Iacampo, Jennifer

Iacampo, Jennifer is an individual health care provider with primary practice located at 150 Mansfield Ave , Willimantic CT 06226-2026. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Iacampo, Jennifer can be contacted via phone (860) 456-2232.

Contact Information

Primary practice address
150 Mansfield Ave Willimantic CT 06226-2026
Phone: (860) 456-2232
Fax: (860) 456-2256
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 008171 Connecticut

Profile Details

NPI number 1225221724
LBN Legal business name Iacampo, Jennifer
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 20th, 2007
Last updated Jul 12th, 2012 - about 14 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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Identifiers

StateTypeNumberIssuer
All States NPI 1225221724 NPPES
Connecticut Other 080008171 ANTHEM BC
Connecticut MEDICAID 004271003 ANTHEM BC

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