Provider Demographics
NPI:1568554749
Name:JAMIL, MUJGAN
Entity Type:Individual
Prefix:DR
First Name:MUJGAN
Middle Name:
Last Name:JAMIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 SACHEM ST
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-4128
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:119 SACHEM ST
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-4128
Practice Address - Country:US
Practice Address - Phone:860-889-0222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT043164207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT0001499OtherCIGNA
CT002547504001OtherUNITED HEATLH
CT431640OtherCONNECTICARE
CT2V7380OtherHEALTH NET
CT7249675OtherAETNA
CTP3657672OtherOXFORD
CT010043164CT01OtherBLUECROSS AND BLUE SHIELD
CT002547504001OtherUNITED HEATLH
CT0001499OtherCIGNA