Provider Demographics
NPI:1245448695
Name:SCHIMMEL, JENNIFER J (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:J
Last Name:SCHIMMEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:J
Other - Last Name:WOLFSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:280 CHESTNUT STREET
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199-1619
Mailing Address - Country:US
Mailing Address - Phone:413-794-5700
Mailing Address - Fax:
Practice Address - Street 1:330 MAIN STREET
Practice Address - Street 2:3RD FLOOR, SUITE C&D
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01199-1619
Practice Address - Country:US
Practice Address - Phone:413-794-7394
Practice Address - Fax:413-794-7136
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2011-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA231323207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110076147AMedicaid
MA110076147AMedicaid