Jerome William Takiff, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

21436 Issued in CT

Practice address

895 East Main Street
Torrington, CT 06790

Phone

(860) 489-1291

Fax

(860) 489-1804

NPI assigned

Jul 21, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• University of Connecticut Health Center

  dba University Physicians

  • General Practice Physician
  • Farmington, CT
  • NPI 1720083769

  Internal Medicine

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339372800000",
    "number": "1699796441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "895 EAST MAIN STREET",
            "city": "TORRINGTON",
            "state": "CT",
            "postal_code": "06790",
            "telephone_number": "860-489-1291",
            "fax_number": "860-489-1804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 EAST MAIN STREET",
            "city": "TORRINGTON",
            "state": "CT",
            "postal_code": "06790",
            "telephone_number": "860-489-1291",
            "fax_number": "860-489-1804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAKIFF",
        "first_name": "JEROME",
        "middle_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2012-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "21436",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CT",
            "license": "21436",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004394904",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP UPIN",
            "identifier": "C01177",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jane Marie Szollosy, RPT
• Sandra J Szymanski
• Ali Oliver Taeb, LMFT, LADC
• Heidi Taggart
• Yasser Tajali, M.D.
• Shannon Elizabeth Tallon
• Ashita Dilipkumar Talsania, M.D.
• Target
• Korinn Marie Taylor, LPCA
• Lauren Taylor, OT

• Internal Medicine Physician in Torrington, CT
• Providers in Torrington, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.