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NPI Code Detail

MEDICARE: DR. JENNIFER L. DREILING MD

MEDICARE: DR. JENNIFER L. DREILING MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207ZP0101XAnatomic Pathology Physician69517CT
2207ZP0102XAnatomic Pathology & Clinical Pathology PhysicianMD044070DC
3390200000XStudent in an Organized Health Care Education/Training Program
4208D00000XGeneral Practice Physician69517CT

General Provider Information

NPI Number : 1922203009
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIFER L. DREILING MD
Provider Business Mailing Address
First Line : 76 BATTERSON PARK RD STE 106
Second Line :
City : FARMINGTON
State : CT
Zip : 06032-2571
Country : US
Telephone Number : 703-635-8976
Fax Number : 203-879-0834
Provider Business Practice Location Address
First Line : 76 BATTERSON PARK RD STE 106
Second Line :
City : FARMINGTON
State : CT
Zip : 06032-2571
Country : US
Telephone Number : 703-635-8976
Fax Number : 203-879-0834
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2007
Last Update Date : 08/10/2022

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