Jack H Adler, MD
Individual provider Active NPI Internal Medicine Physician · Bristol, CT
NPI 1851301709 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1851301709
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 026809 (CT)
- Practice address
- 621 Terryville Ave
Bristol, CT 06010-4078 - Phone
- (860) 583-0053
- Fax
- (860) 583-0059
- NPI assigned
- Aug 9, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 026809 | CT | MD | Internal Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 026809 | CT | Yes |
Addresses
Primary practice location
621 Terryville Ave
Bristol, CT 06010-4078
Mailing address
4 Farm Springs Rd
Prohealth Physicians
Farmington, CT 06032-2573
Phone (860) 284-5200
Other providers in Bristol, CT
- Kori Ellen Abarzua
- Achieving Wellness LLC
- Carolina Acosta Pabon
- Yomaliz L Adams
- Susan Adeola Adeife Lee
- Sharon Okin Adler
- Admire Dental LLC
- Advance Care Within LLC
- Affectionate Home Care Inc.
- James D Affenito
All providers in Bristol, CT · Internal Medicine Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.