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NPI Code Detail

MEDICARE: DR. KELSEY ANN JARDINE PHARMD.

MEDICARE: DR. KELSEY ANN JARDINE 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
1183500000XPharmacist059242NY

General Provider Information

NPI Number : 1831570423
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KELSEY ANN JARDINE PHARMD.
Provider Business Mailing Address
First Line : 878 LONG POND RD
Second Line :
City : ROCHESTER
State : NY
Zip : 14612-3049
Country : US
Telephone Number : 585-723-3051
Fax Number : 585-723-9096
Provider Business Practice Location Address
First Line : 878 LONG POND RD
Second Line :
City : ROCHESTER
State : NY
Zip : 14612-3049
Country : US
Telephone Number : 585-723-3051
Fax Number : 585-723-9096
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2015
Last Update Date : 06/09/2015

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