Provider Demographics
NPI:1740409952
Name:JENNIFER E. MYER MD LLC
Entity Type:Organization
Organization Name:JENNIFER E. MYER MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIOTER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:EMILY
Authorized Official - Last Name:MYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-752-1733
Mailing Address - Street 1:261 BRADLEY ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-1104
Mailing Address - Country:US
Mailing Address - Phone:203-752-1733
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0396852084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty