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General NPI Number Information
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NPI Number | 1912212572
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Entity Type | Individual
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Provider Name | JASON PAUL DENNIE R.PH., PHARM. D
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Gender | Male
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Dates
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Enumeration Date | 08/06/2010
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Last Update Date | 01/22/2019
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Provider Practice Location Address
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Address Line | 1455 E RIDGE RD
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City | ROCHESTER
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State | NY
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Zip | 14621-2006
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Country | US
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Telephone | 585-974-5000
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Fax | 585-974-5009
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Provider Business Mailing Address
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Address Line | 9 BRIGHAM CIR
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City | HONEOYE FALLS
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State | NY
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Zip | 14472-9240
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Country | US
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Telephone | 315-576-7655
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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 | 054572
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License Number State | NY
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