Provider Demographics
NPI:1124747662
Name:DIGIROLAMO, JENNA L (DPT)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:L
Last Name:DIGIROLAMO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 LOEFFLER RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-2256
Mailing Address - Country:US
Mailing Address - Phone:860-726-2410
Mailing Address - Fax:
Practice Address - Street 1:10 LOEFFLER RD
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-2256
Practice Address - Country:US
Practice Address - Phone:860-726-2410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-26
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT9857225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist