Healthcare Provider Details

I. General information

NPI: 1225360019
Provider Name (Legal Business Name): JENNIFER LIUZZI R.PH.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2010
Last Update Date: 02/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8181 SENECA TPKE
CLINTON NY
13323-1100
US

IV. Provider business mailing address

546 BRETTS WAY
WHITESBORO NY
13492-3210
US

V. Phone/Fax

Practice location:
  • Phone: 315-793-8945
  • Fax: 315-724-2966
Mailing address:
  • Phone: 315-736-0063
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number46812
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: