DR. JEFFREY PAUL FENNELLY (NPI# 1760770531) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760770531 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY PAUL FENNELLY |
| Credential | MD |
| Practice Address |
97 Gray St Arlington MA 02476-6334 |
| Practice Telephone | 7818357208 |
| Mailing Telephone | 7818357208 |
| Enumeration Date | 2011-07-14 |
| Last Update Date | 2019-11-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208D00000X | General Practice | 30138901 | NY | Allopathic & Osteopathic Physicians |
| Y | 208D00000X | General Practice | 0101253447 | VA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 55 Knapp Rd, South Salem, NY 105901016 | 9145551212 |
| Street Address |
97 GRAY ST |
| City | ARLINGTON |
| State | MA |
| Zip Code | 02476-6334 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508479106 | Terry Ellis Real | Social Worker | 754 Massachusetts Avene, Arlington, MA 02476 | 2020-08-25 |
| 1992313340 | Shivam Kamlesh Gosai | Counselor | 670r Massachusetts Av/, Whittemore Robbins House, Arlington, MA 02476 | 2020-07-21 |
| 1912559246 | Hilary Scheintaub | Student in an Organized Health Care Education/Training Program | Boston College Biology Department, 355 Higgins Hall, Chestnut Hill, MA 02476 | 2019-07-16 |
| 1871076075 | Lourie August | Social Worker | Council On Aging, 27 Maple St, Arlington, MA 02476 | 2018-09-13 |
| 1235612904 | Marci Susan Shapiro-ide | Social Worker | Arlington Council On Aging, 27 Maple Street, Arlington, MA 02476 | 2018-09-10 |
| 1336621796 | Elizabeth W Rollins | Social Worker | 47 Ottawa Rd, Arlington, MA 02476 | 2018-09-02 |
| 1417439878 | Emily F Freisen | Occupational Therapist | 22 Mill Street Suite 302, Arlinton, MA 02476 | 2018-09-02 |
| 1093294886 | Michael Greenstein | Social Worker | Ottoson Middle School, 63 Acton St., Arlington, MA 02476 | 2018-08-13 |
| 1932627577 | Lori Peters | Counselor | 691 Massachusetts Ave. Suite #5, Arlington, MA 02476 | 2017-09-05 |
| 1235651290 | Stephen Marshall | Psychologist | 259 Massachusetts Ave., Arlington, MA 02476 | 2017-07-12 |
| Find all providers in zip 02476 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
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| 1811311350 | Withinme Md | General Practice | 5275 Lee Hwy Ste 201, Arlington, VA 22207-1619 | 2014-02-04 |
| 1669733689 | Murray R Strauss, Md Professional Association | General Practice | 516 Ridings Pl Apt 175, Arlington, TX 76011-3761 | 2012-06-06 |
| 1861753238 | Carmen Denise Williams | General Practice | 1435 N Courthouse Rd, Arlington, VA 22201-2640 | 2012-06-01 |
| 1124349923 | Lachman Investment Management Services Inc | General Practice | 1001 N Fillmore St, Arlington, VA 22201-2169 | 2010-06-15 |
| 1477792240 | Britt Holdings LLC | General Practice | 702 Ih West, Ste 100, Arlington, TX 76017-5854 | 2009-02-18 |
| 1033364773 | Thuan Dinh Ngo | General Practice | 3801 N. Fairfax Drive, Suite 52, Arlington, VA 22203 | 2008-11-21 |
| 1902070188 | The Neighborhood Doctor | General Practice | 5201 S Cooper St Ste 111, Arlington, TX 76017-5964 | 2008-04-17 |
| 1598945123 | Robert Ure, M.d. | General Practice | 4738 Little Rd, Arlington, TX 76017-1058 | 2007-11-12 |
| 1427240605 | Kirsten Van Steenberg Ball | General Practice | 5556 16th St N, Arlington, VA 22205-2718 | 2007-08-13 |
| 1629299789 | Larry D Sprowls | General Practice | 2301 North Collins, Arlington, TX 76011 | 2007-05-02 |
| Find all providers in ARLINGTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.