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General NPI Number Information
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NPI Number | 1457515637
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Entity Type | Individual
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Provider Name | JIJIMOL LAWRENCE RPH
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Gender | Female
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Dates
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Enumeration Date | 07/16/2008
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Last Update Date | 07/06/2020
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Provider Practice Location Address
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Address Line | 1250 UPPER FRONT ST STE 18
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City | BINGHAMTON
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State | NY
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Zip | 13901-1069
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Country | US
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Telephone | 607-723-8291
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Fax | 607-651-9992
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Provider Business Mailing Address
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Address Line | 1250 UPPER FRONT STREET
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City | BINGHAMTON
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State | NY
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Zip | 13901-1608
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Country | US
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Telephone | 607-723-8291
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Fax | 607-651-9992
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 048399
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License Number State | NY
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