Healthcare Provider Details

I. General information

NPI: 1912220674
Provider Name (Legal Business Name): WENDY SUE JONES PHARMACIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: WENDY SUE JONES PHARMACIST

II. Dates (important events)

Enumeration Date: 03/10/2010
Last Update Date: 03/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 W AMES CT
PLAINVIEW NY
11803-2304
US

IV. Provider business mailing address

161 BERRY HILL RD
SYOSSET NY
11791-2608
US

V. Phone/Fax

Practice location:
  • Phone: 516-938-8080
  • Fax:
Mailing address:
  • Phone: 516-496-7191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number034269
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: