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General NPI Number Information
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NPI Number | 1699761346
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Entity Type | Individual
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Provider Name | JENIFER SIEGELMAN MD
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Gender | Female
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Dates
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Enumeration Date | 09/27/2005
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Last Update Date | 08/20/2013
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Provider Practice Location Address
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Address Line | 326 WASHINGTON ST
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City | NORWICH
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State | CT
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Zip | 06360-2740
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Country | US
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Telephone | 860-889-8331
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 9132 ATT:SHARON SILVA
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City | BROOKLINE
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State | MA
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Zip | 02446-9132
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Country | US
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Telephone | 800-927-0002
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Fax |
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 040352
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 257053
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License Number State | MA
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