Fantasia, Jennifer

Fantasia, Jennifer is an individual health care provider with primary practice located at 33 Kendall St , Worcester MA 01605-2726. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Urology. Allopathic & Osteopathic Physicians / Urology is her primary health care specialty. Fantasia, Jennifer can be contacted via phone (083) 348-7655.

Contact Information

Primary practice address
33 Kendall St Worcester MA 01605-2726
Phone: (083) 348-7655
Fax: (508) 334-9477
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X LP03299 Rhode Island
Allopathic & Osteopathic Physicians / Urology 208800000X 283649 Massachusetts

Profile Details

NPI number 1053799726
LBN Legal business name Fantasia, Jennifer
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 13th, 2015
Last updated Oct 27th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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