Provider Demographics
NPI:1558327460
Name:VASINDA, JENNIFER P (DO)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:P
Last Name:VASINDA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:777 RURAL AVE
Mailing Address - Street 2:6TH FLOOR
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-3109
Mailing Address - Country:US
Mailing Address - Phone:570-323-3671
Mailing Address - Fax:570-321-0648
Practice Address - Street 1:777 RURAL AVE
Practice Address - Street 2:6TH FLOOR
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-3109
Practice Address - Country:US
Practice Address - Phone:570-323-3671
Practice Address - Fax:570-321-0648
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS013171207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology