Provider Demographics
NPI:1760736904
Name:ZUCCARELLI, JENNIFER E (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:E
Last Name:ZUCCARELLI
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:440 N BARRANCA AVE STE 1801
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723-1722
Mailing Address - Country:US
Mailing Address - Phone:800-924-7811
Mailing Address - Fax:877-349-1868
Practice Address - Street 1:7008 SALEM AVE # 117
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-2226
Practice Address - Country:US
Practice Address - Phone:800-924-7811
Practice Address - Fax:877-349-1868
Is Sole Proprietor?:No
Enumeration Date:2012-11-08
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV25130207Q00000X
GA68815207Q00000X
FLME142458207Q00000X
PAMD472163207Q00000X
IL036.163434207Q00000X
OH35C.000375207Q00000X
MIEMC0002887207Q00000X
MO2023028371207Q00000X
SC90714207Q00000X
KYC1322207Q00000X
TN67633207Q00000X
TXS0249207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine