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General NPI Number Information
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NPI Number | 1689997983
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Entity Type | Individual
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Provider Name | LOVENESS JACOB KAALE-SENELORM PHARM.D
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Gender | Female
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Dates
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Enumeration Date | 03/01/2010
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Last Update Date | 03/01/2010
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Provider Practice Location Address
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Address Line | 78 MAIN AVE
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City | PASSAIC
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State | NJ
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Zip | 07055-4466
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Country | US
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Telephone | 973-778-0971
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Fax |
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Provider Business Mailing Address
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Address Line | 18 METROPOLITAN OVAL APT 5D
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City | BRONX
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State | NY
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Zip | 10462-6791
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Country | US
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Telephone | 973-752-8272
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Fax |
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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 | 28RI03247700
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License Number State | NJ
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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 | 054350
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License Number State | NY
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