Individual
JENNA LYN DADDARIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
55 FRUIT ST STE 435, BOSTON, MA 02114-2621
(617) 726-2000
Mailing address
17 LOCKEWOOD DR, FRANKLIN, MA 02038-2347
(508) 509-2735
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA7297
MA
363AM0700X
Medical Physician Assistant
23015924
NY
Other
Enumeration date
09/06/2012
Last updated
09/22/2020
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