LAWRENCE M. JACOBY, M.D., PC
Physician Assistant at Avon Rd, Avon, CT

License number
Connecticut 022522
Category
Medical Practice
Type
Specialist
License number
Connecticut 016756
Category
Medical Practice
Type
Specialist
License number
Connecticut 000178
Category
Nursing
Type
Physician Assistant
Owner
Name: MS. JODIE JACOBY
Title: OFFICE MANAGER
Phone: (860) 673-1667
Address
Address
18 W Avon Rd, Avon, CT 06001
National Provider ID: 1942405246
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about LAWRENCE M. JACOBY, M.D., PC at bizstanding.com

LAWRENCE M. JACOBY, M.D.,P.C

Avon Professional Ctr, Avon, CT 06001

Status:
Inactive
Registration:
Jan 16, 1980
State ID:
0100858
Business type:
Stock
SECRETARYs:
Lawrence M. Jacoby, M.d (PRESIDENT), Avon Professional Ctr, Avon, CT 06001 (Mailing)
18 Governors Row, West Hartford, CT 06117 (Physical),Doris D'ambrosio (SECRETARY), 784 Farmington Ave, West Hartford, CT 06119 (Mailing)
4 Tanglewood Dr, Canton, CT 06019 (Physical)
Agent:
Howard A Roseman Esq,799 Main St, Hartford, CT 06103 (Mailing)
12 Rocklyn Ct, West Simsbury, CT 06092 (Physical)

Physician Assistant licenses in Connecticut










Other Doctors licenses in Connecticut