Provider Demographics
NPI:1366881096
Name:CIRINO, JENNIFER ASHLEY (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ASHLEY
Last Name:CIRINO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2799 W GRAND BLVD
Mailing Address - Street 2:CFP 124
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202
Mailing Address - Country:US
Mailing Address - Phone:313-916-2101
Mailing Address - Fax:313-916-8007
Practice Address - Street 1:2799 W GRAND BLVD # 126
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-2689
Practice Address - Country:US
Practice Address - Phone:313-916-2101
Practice Address - Fax:313-916-8007
Is Sole Proprietor?:No
Enumeration Date:2013-06-15
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI43011175692086S0102X, 2086S0127X
MI4301103589208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery