Healthcare Provider Details

I. General information

NPI: 1346048519
Provider Name (Legal Business Name): JENNIFER E ZOLLO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/04/2025
Last Update Date: 03/04/2025
Certification Date: 03/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 BARDEN ST
AGAWAM MA
01001-3542
US

IV. Provider business mailing address

11 BARDEN ST
AGAWAM MA
01001-3542
US

V. Phone/Fax

Practice location:
  • Phone: 413-237-7239
  • Fax:
Mailing address:
  • Phone: 413-237-7239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN229198
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: