Provider Demographics
NPI:1881906139
Name:ABELLARD, JESSICA (PSYCHIATRIST)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:
Last Name:ABELLARD
Suffix:
Gender:F
Credentials:PSYCHIATRIST
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:400 COLUMBUS AVENUE
Mailing Address - Street 2:CREDENTIALING SPECIALIST
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06519-1233
Mailing Address - Country:US
Mailing Address - Phone:203-503-3000
Mailing Address - Fax:203-503-6515
Practice Address - Street 1:266 DIXWELL AVENUE
Practice Address - Street 2:NORTHSIDE
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-1134
Practice Address - Country:US
Practice Address - Phone:203-503-3470
Practice Address - Fax:203-503-3478
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-01
Last Update Date:2019-08-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD4601272084P0800X
CT565712084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004235918Medicaid