Provider Demographics
NPI:1831327428
Name:PRESNAR, JENNIFER PISCITELLA (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:PISCITELLA
Last Name:PRESNAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:M
Other - Last Name:PISCITELLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:183 ENCLAVE DR
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16105-3207
Mailing Address - Country:US
Mailing Address - Phone:724-654-9910
Mailing Address - Fax:724-654-9887
Practice Address - Street 1:183 ENCLAVE DR
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16105-3207
Practice Address - Country:US
Practice Address - Phone:724-654-9910
Practice Address - Fax:724-654-9887
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2015-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD445297208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics