Provider Demographics
NPI:1528561800
Name:INHOUSE MEDICAL LLC
Entity Type:Organization
Organization Name:INHOUSE MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:JESKE
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:203-518-5232
Mailing Address - Street 1:276 HIGHLAND AVE STE A2
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708-3022
Mailing Address - Country:US
Mailing Address - Phone:203-518-5232
Mailing Address - Fax:888-372-6480
Practice Address - Street 1:276 HIGHLAND AVE STE A2
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-3022
Practice Address - Country:US
Practice Address - Phone:203-518-5232
Practice Address - Fax:888-372-6480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-13
Last Update Date:2024-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT207R00000X, 261QP2300X, 363L00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care