Provider Demographics
NPI:1164810156
Name:CHIAFFARANO, JEANINE (DO)
Entity Type:Individual
Prefix:
First Name:JEANINE
Middle Name:
Last Name:CHIAFFARANO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2201 CHAPEL AVE W
Mailing Address - Street 2:PATHOLOGY DEPARTMENT
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-2048
Mailing Address - Country:US
Mailing Address - Phone:856-488-6560
Mailing Address - Fax:856-488-6624
Practice Address - Street 1:2201 CHAPEL AVE W
Practice Address - Street 2:PATHOLOGY DEPARTMENT
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-2048
Practice Address - Country:US
Practice Address - Phone:856-488-6560
Practice Address - Fax:856-488-6624
Is Sole Proprietor?:No
Enumeration Date:2014-12-30
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB10072100207ZP0102X
PAOS019944207ZC0500X, 207ZP0102X
NY277750207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology