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NPI Code Detail

MEDICARE: DR. JENNIFER S PETERS PHARMD

MEDICARE: DR. JENNIFER S PETERS PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist055571NY
2183500000XPharmacist051292650IL

General Provider Information

NPI Number : 1538459144
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIFER S PETERS PHARMD
Provider Business Mailing Address
First Line : 4999 STATE HIGHWAY 30
Second Line :
City : AMSTERDAM
State : NY
Zip : 12010-7521
Country : US
Telephone Number : 518-843-6661
Fax Number :
Provider Business Practice Location Address
First Line : 4999 STATE HIGHWAY 30
Second Line :
City : AMSTERDAM
State : NY
Zip : 12010-7521
Country : US
Telephone Number : 518-843-6661
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2011
Last Update Date : 04/15/2011

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