Provider Demographics
NPI:1891804415
Name:JAKUBOWITCH, CATHERINE ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:ANN
Last Name:JAKUBOWITCH
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Gender:F
Credentials:MD
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Mailing Address - Street 1:69 FEDERAL ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04101-4260
Mailing Address - Country:US
Mailing Address - Phone:207-775-0110
Mailing Address - Fax:207-772-7702
Practice Address - Street 1:69 FEDERAL ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-4260
Practice Address - Country:US
Practice Address - Phone:207-775-0110
Practice Address - Fax:207-772-7702
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2017-03-30
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Provider Licenses
StateLicense IDTaxonomies
ME0147352084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME672784Medicare UPIN
MEMM7312Medicare Oscar/Certification