Provider Demographics
NPI:1679704225
Name:GIFFUNE, JENNIFER L (RD LDN)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:L
Last Name:GIFFUNE
Suffix:
Gender:F
Credentials:RD LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:354 BIRNIE AVENUE
Mailing Address - Street 2:HCPA
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01107-1109
Mailing Address - Country:US
Mailing Address - Phone:413-733-3470
Mailing Address - Fax:413-733-4298
Practice Address - Street 1:354 BIRNIE AVE
Practice Address - Street 2:HAMPDEN COUNTY PHYSICIAN ASSOCIATES, LLC
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1108
Practice Address - Country:US
Practice Address - Phone:413-733-3470
Practice Address - Fax:413-733-4298
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-30
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1132133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000000105101OtherBMC HEALTHNET
MA42791OtherHEALTH NEW ENGLAND
MA42791OtherHEALTH NEW ENGLAND
MAMT0237Medicare PIN