Healthcare Provider Details

I. General information

NPI: 1184387805
Provider Name (Legal Business Name): KATHLEEN M JONES PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2021
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6040 TARBELL RD
SYRACUSE NY
13206-1348
US

IV. Provider business mailing address

6040 TARBELL RD
SYRACUSE NY
13206
US

V. Phone/Fax

Practice location:
  • Phone: 888-843-2040
  • Fax:
Mailing address:
  • Phone: 888-843-2040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number067954
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: