Provider Demographics
NPI:1902254741
Name:GASSNER, JENNIFER MARY (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:MARY
Last Name:GASSNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-5352
Mailing Address - Country:US
Mailing Address - Phone:401-727-4800
Mailing Address - Fax:401-921-6924
Practice Address - Street 1:21 DIVISION ST
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-5352
Practice Address - Country:US
Practice Address - Phone:401-727-4800
Practice Address - Fax:401-921-6924
Is Sole Proprietor?:No
Enumeration Date:2016-06-02
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.068806207V00000X
RIMD17638207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology