Provider Demographics
NPI:1043466584
Name:SCARPONE, JENNIFER MARIE (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MARIE
Last Name:SCARPONE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 MALLANE LN
Mailing Address - Street 2:1-F
Mailing Address - City:NAUGATUCK
Mailing Address - State:CT
Mailing Address - Zip Code:06770-1918
Mailing Address - Country:US
Mailing Address - Phone:973-902-9667
Mailing Address - Fax:
Practice Address - Street 1:111 MALLANE LN
Practice Address - Street 2:1-F
Practice Address - City:NAUGATUCK
Practice Address - State:CT
Practice Address - Zip Code:06770-1918
Practice Address - Country:US
Practice Address - Phone:973-902-9667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-15
Last Update Date:2008-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT39020000XOtherTAXONOMY