Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jesse Samuel Goldblum

Individual provider Registered Nurse · NPI 1407637895

Jesse Samuel Goldblum is a Registered Nurse in Hartford, Connecticut. Licensed in Connecticut. Registered with an NPI since 2023.

Licensed in
CT
In the registry since
2023
Specialties on file
2

Practice location Address checks out

1680 Albany Ave
Hartford, CT 06105-1001
Phone: (860) 297-0520
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 13775 (CT)
Registered Nurse Taxonomy 163W00000X · Licence 196780 (CT)

Record details

NPI number1407637895
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 11, 2023
Last updated in NPPESJanuary 4, 2025
Certification dateJanuary 4, 2025
Mailing address55 Marvel Rd Apt B2, New Haven, CT 06515-2169

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