Provider Demographics
NPI:1487601845
Name:AMOROSINO, JESSICA S (MD)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:S
Last Name:AMOROSINO
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 1:100 BOSTON RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:GROTON
Mailing Address - State:MA
Mailing Address - Zip Code:01450-1860
Mailing Address - Country:US
Mailing Address - Phone:978-448-8282
Mailing Address - Fax:
Practice Address - Street 1:100 BOSTON RD
Practice Address - Street 2:SUITE F
Practice Address - City:GROTON
Practice Address - State:MA
Practice Address - Zip Code:01450-1860
Practice Address - Country:US
Practice Address - Phone:978-448-8282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA227715208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics