Basic Information
| Provider Information | |||||||||
| NPI: | 1780788349 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | JASTREBOFF | ||||||||
| FirstName: | ANIA | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | M.D., PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 208020 | ||||||||
| Address2: | YALE UNIVERSITY SCHOOL OF MEDICINE - ENDOCRINOLOGY | ||||||||
| City: | NEW HAVEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 065208020 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037371932 | ||||||||
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| Practice Location | |||||||||
| Address1: | 333 CEDAR ST | ||||||||
| Address2: | YALE UNIVERSITY SCHOOL OF MEDICINE - ENDOCRINOLOGY | ||||||||
| City: | NEW HAVEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 065103206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037371932 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/12/2006 | ||||||||
| LastUpdateDate: | 01/12/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 048393 | CT | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208000000X | 048393 | CT | N | Allopathic & Osteopathic Physicians | Pediatrics | 207RE0101X | 048393 | CT | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism | 2080P0205X | 048393 | CT | N | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Endocrinology |
No ID Information.