Provider Demographics
NPI:1952470726
Name:MCDONNELL, JENNIFER SUZANNE (PA-C)
Entity Type:Individual
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First Name:JENNIFER
Middle Name:SUZANNE
Last Name:MCDONNELL
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:2139 SILAS DEANE HWY
Mailing Address - Street 2:SUITE H
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-2336
Mailing Address - Country:US
Mailing Address - Phone:860-257-4131
Mailing Address - Fax:860-257-4519
Practice Address - Street 1:85 SEYMOUR ST
Practice Address - Street 2:SUITE 1000
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-5501
Practice Address - Country:US
Practice Address - Phone:860-246-2571
Practice Address - Fax:860-246-3691
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2012-10-26
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Provider Licenses
StateLicense IDTaxonomies
CT001834363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTD400077291Medicare PIN