MEDICARE: JENNIFER M MARANGONI PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	50.002379RX	OH

General Provider Information

NPI Number	:	1306880695
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER M MARANGONI PA

Provider Business Mailing Address
First Line	:	2600 AIRPORT DR STE 200
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43219-2242
Country	:	US
Telephone Number	:	614-259-0910
Fax Number	:	614-259-0614

Provider Business Practice Location Address
First Line	:	2600 AIRPORT DR STE 200
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43219-2242
Country	:	US
Telephone Number	:	614-259-0910
Fax Number	:	614-259-0614

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2006
Last Update Date	:	07/26/2023

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Directions to “ JENNIFER M MARANGONI PA” Practice Location

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