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General NPI Number Information
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NPI Number | 1104817212
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Entity Type | Individual
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Provider Name | JENNIFER MARIE PAMFILIE M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/31/2005
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Last Update Date | 01/25/2021
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Provider Practice Location Address
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Address Line | 5655 HUDSON DR STE 303
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City | HUDSON
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State | OH
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Zip | 44236-4454
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Country | US
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Telephone | 330-800-4800
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Fax | 330-653-3016
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Provider Business Mailing Address
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Address Line | 5655 HUDSON DR STE 303
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City | HUDSON
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State | OH
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Zip | 44236-4454
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Country | US
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Telephone | 330-800-4800
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Fax | 330-653-3016
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35071229P
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35-071229
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License Number State | OH
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