Provider Demographics
NPI:1609972538
Name:MYER, JENNIFER EMILY (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:EMILY
Last Name:MYER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 WAKEFIELD ST
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06517-1329
Mailing Address - Country:US
Mailing Address - Phone:203-407-0136
Mailing Address - Fax:
Practice Address - Street 1:261 BRADLEY ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-1104
Practice Address - Country:US
Practice Address - Phone:203-752-1733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0396852084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry