JENNIFER DODGE PA NPI 1558402230

NPI Information

NPI: 1558402230
Provider Name: JENNIFER DODGE, PA
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Organization: CONNECTICUT GASTROENTEROLOGY CONSULTANTS PC

PECOS Registration: Yes

Address:
40 TEMPLE ST
SUITE 4A
NEW HAVEN, CT
ZIP 06510
Phone: (203) 777-0304
Get Directions

Jennifer Dodge, PA is a medical physician assistant in New Haven, CT with 25 years of experience. Jennifer Dodge, PA NPI is 1558402230. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

40 TEMPLE ST
SUITE 4A
NEW HAVEN, CT
ZIP 06510-715
Phone: (203) 777-0304
Fax: (203) 401-4687

The NPI 1558402230 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/8/2007 and was last updated on 2/13/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	000907	CONNECTICUT	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	P40174	MEDICARE UPIN	CONNECTICUT
2	970000888	MEDICARE ID-TYPE UNSPECIFIED	CONNECTICUT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »