Provider Demographics
NPI:1407933724
Name:ZAMPOGNA, JENNIFER CARCHIDI (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:CARCHIDI
Last Name:ZAMPOGNA
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 1:950 WOODLAND ST
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-4373
Mailing Address - Country:US
Mailing Address - Phone:717-766-0500
Mailing Address - Fax:717-766-0585
Practice Address - Street 1:950 WOODLAND ST
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-4373
Practice Address - Country:US
Practice Address - Phone:717-766-0500
Practice Address - Fax:717-766-0585
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD418381208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP00047884Medicare PIN
PAH69975Medicare UPIN
PA062111U6SMedicare ID - Type Unspecified