Healthcare Provider Details

I. General information

NPI: 1194748376
Provider Name (Legal Business Name): JENNIFER CALOIA RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 EAST MAIN STREET
MORRISVILLE NY
13408
US

IV. Provider business mailing address

4229 STONE BRIDGE RD
MORRISVILLE NY
13408-1402
US

V. Phone/Fax

Practice location:
  • Phone: 315-684-3171
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number037369
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: