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NPI Code Detail

MEDICARE: DR. JENNIFER JOHNSON PHARMD

MEDICARE: DR. JENNIFER JOHNSON 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
1183500000XPharmacist067974NY

General Provider Information

NPI Number : 1720703028
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIFER JOHNSON PHARMD
Provider Business Mailing Address
First Line : 300 STARBOARD SIDE LN APT 211
Second Line :
City : WEBSTER
State : NY
Zip : 14580-2273
Country : US
Telephone Number : 585-208-2545
Fax Number :
Provider Business Practice Location Address
First Line : 2580 E HENRIETTA RD
Second Line :
City : ROCHESTER
State : NY
Zip : 14623-4526
Country : US
Telephone Number : 585-321-2581
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2022
Last Update Date : 10/10/2022

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