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General NPI Number Information
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NPI Number | 1497012546
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Entity Type | Individual
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Provider Name | JOHN JAY JENSEN R.PH
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Gender | Male
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Dates
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Enumeration Date | 04/13/2012
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Last Update Date | 04/13/2012
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Provider Practice Location Address
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Address Line | 80 S WHITE HORSE PIKE
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City | HAMMONTON
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State | NJ
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Zip | 08037-1862
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Country | US
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Telephone | 609-567-4275
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Fax | 609-567-4283
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Provider Business Mailing Address
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Address Line | 2150 7TH AVE
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City | HAMMONTON
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State | NJ
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Zip | 08037-4300
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Country | US
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Telephone | 609-567-4275
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Fax | 609-567-4283
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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 | 271058
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 28RI02273300
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License Number State | NJ
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