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NPI Code Detail

MEDICARE: JESSICA LAUB PHARMD

MEDICARE: JESSICA LAUB PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistRP452825PA

General Provider Information

NPI Number : 1972288215
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA LAUB PHARMD
Provider Business Mailing Address
First Line : 102 BERKELEY PL APT 1F
Second Line :
City : BROOKLYN
State : NY
Zip : 11217-3686
Country : US
Telephone Number : 267-981-1091
Fax Number :
Provider Business Practice Location Address
First Line : 506 6TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11215-3609
Country : US
Telephone Number : 646-413-9626
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2023
Last Update Date : 06/15/2023

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