Healthcare Provider Details

I. General information

NPI: 1477007946
Provider Name (Legal Business Name): JENNIFER BARLEKOFF PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2016
Last Update Date: 08/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5430 PEACH ST
ERIE PA
16509-2602
US

IV. Provider business mailing address

1121 W 21ST ST
ERIE PA
16502-2309
US

V. Phone/Fax

Practice location:
  • Phone: 814-868-4624
  • Fax:
Mailing address:
  • Phone: 814-873-8269
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP450768
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: