Provider Demographics
NPI:1902541196
Name:MARKIEL, JAN TADEUSZ (MD)
Entity type:Individual
Prefix:MR
First Name:JAN
Middle Name:TADEUSZ
Last Name:MARKIEL
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 STRAWBERRY HILL AVE UNIT 803
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-8500
Mailing Address - Country:US
Mailing Address - Phone:332-260-5097
Mailing Address - Fax:
Practice Address - Street 1:267 GRANT STREET
Practice Address - Street 2:BRIDGEPORT HOSPITAL, DEPARTMENT OF MEDICINE
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06610
Practice Address - Country:US
Practice Address - Phone:203-384-3000
Practice Address - Fax:203-384-4294
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-02
Last Update Date:2025-03-18
Deactivation Date:2023-01-30
Deactivation Code:
Reactivation Date:2023-02-06
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program