Provider Demographics
NPI:1356673594
Name:SCHMERHOLD, JENNIFER CLAIRE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:CLAIRE
Last Name:SCHMERHOLD
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1933 VICTORY BLVD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-3519
Mailing Address - Country:US
Mailing Address - Phone:718-447-0300
Mailing Address - Fax:
Practice Address - Street 1:1933 VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-3519
Practice Address - Country:US
Practice Address - Phone:718-447-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-12
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053362183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist