Civitella, Jennifer Ann

Civitella, Jennifer Ann is an individual health care provider with primary practice located at 454 Old Street Rd Suite 207, Peterborough NH 03458-1200. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Civitella, Jennifer Ann can be contacted via phone (603) 924-4664.

Contact Information

Primary practice address
454 Old Street Rd Suite 207 Peterborough NH 03458-1200
Phone: (603) 924-4664
Fax: (603) 924-8653
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 12233 New Hampshire

Profile Details

NPI number 1225012586
LBN Legal business name Civitella, Jennifer Ann
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2005
Last updated Mar 10th, 2020 - about 4 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 1225012586 NPPES
New Hampshire MEDICAID 30204083

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