Provider Demographics
NPI:1679912851
Name:JABBOUR, JACOB IHSAN (DO)
Entity type:Individual
Prefix:DR
First Name:JACOB
Middle Name:IHSAN
Last Name:JABBOUR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 GRAND ST STE 170
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06052-2016
Mailing Address - Country:US
Mailing Address - Phone:860-224-5650
Mailing Address - Fax:860-224-5952
Practice Address - Street 1:100 GRAND ST STE 170
Practice Address - Street 2:THE HAND CENTER
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06052-2016
Practice Address - Country:US
Practice Address - Phone:860-224-5659
Practice Address - Fax:860-224-5952
Is Sole Proprietor?:No
Enumeration Date:2013-06-20
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS14877208600000X, 2086S0105X
CT72353208600000X, 2086S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
No208600000XAllopathic & Osteopathic PhysiciansSurgery