Individual
JESSICA FENNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
282 WASHINGTON ST, HARTFORD, CT 06106-3322
(860) 545-9970
Mailing address
535 E 70TH ST, NEW YORK, NY 10021-4823
(917) 260-3909
(917) 260-4522
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
70529
CT
2080P0216X
Pediatric Rheumatology Physician
Primary
70529
CT
390200000X
Student in an Organized Health Care Education/Training Program
107775809
CT
Other
Enumeration date
04/04/2016
Last updated
12/24/2024
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