Healthcare Provider Details

I. General information

NPI: 1699377036
Provider Name (Legal Business Name): JENNIFER ZVALENY PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/11/2020
Last Update Date: 11/11/2020
Certification Date: 11/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1810 E MONUMENT ST
BALTIMORE MD
21205-2107
US

IV. Provider business mailing address

2001 BALTIMORE AVE
GAMBRILLS MD
21054-1771
US

V. Phone/Fax

Practice location:
  • Phone: 410-502-5735
  • Fax:
Mailing address:
  • Phone: 410-923-2521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number17973
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: