Provider Demographics
NPI:1003007758
Name:JACOB ZAMSTEIN, MD, LLC
Entity Type:Organization
Organization Name:JACOB ZAMSTEIN, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAMSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-242-2900
Mailing Address - Street 1:701 COTTAGE GROVE RD # C
Mailing Address - Street 2:SUITE 110
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-3080
Mailing Address - Country:US
Mailing Address - Phone:860-242-2900
Mailing Address - Fax:860-242-2250
Practice Address - Street 1:701 COTTAGE GROVE RD # C
Practice Address - Street 2:SUITE 110
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-3080
Practice Address - Country:US
Practice Address - Phone:860-242-2900
Practice Address - Fax:860-242-2250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty