Individual ProviderJessy PaulInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address56 Franklin St, Waterbury, CT 06706-1253(203) 709-8820(646) 318-1760PECOS EnrollmentBased on the most recent information from CMS, provider Jessy Paul is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1790179265Provider TypeIndividualFull NamePaul, JessyGenderFemaleSole ProprietorNoEnumeration Date3/23/2015Last Updated6/14/2019Contact InformationPractice LocationPractice Address56 Franklin St, Waterbury, CT 06706-1253Phone(203) 709-8820Fax(203) 709-3679Mailing LocationMailing Address794 Klondike Ave, Staten Island, NY 10314-4824Phone(646) 318-1760FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense291503New YorkCode207R00000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense54019Connecticut