Healthcare Provider Details

I. General information

NPI: 1477972701
Provider Name (Legal Business Name): JENNIFER L WINSLOW DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2014
Last Update Date: 09/17/2024
Certification Date: 09/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 WRIGHT ST FL 1
PALMER MA
01069-1138
US

IV. Provider business mailing address

280 CHESTNUT STREET 2ND FLOOR
SPRINGFIELD MA
01199-1001
US

V. Phone/Fax

Practice location:
  • Phone: 413-370-5400
  • Fax: 413-284-5559
Mailing address:
  • Phone: 413-794-5700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number283715
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: