Healthcare Provider Details

I. General information

NPI: 1821744087
Provider Name (Legal Business Name): JENAY ARLENE MARTIGNETTI AGACNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2022
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 OLD WINDSOR RD UNIT 3
BLOOMFIELD CT
06002-1419
US

IV. Provider business mailing address

81 OLD WINDSOR RD UNIT 3
BLOOMFIELD CT
06002-1419
US

V. Phone/Fax

Practice location:
  • Phone: 860-966-6727
  • Fax: 475-619-3366
Mailing address:
  • Phone: 860-966-6727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN2258598
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberRN2258598
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN2258598
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: