Provider Demographics
NPI:1376762286
Name:URSO, JENNIFER (RPH, FASCP)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:
Last Name:URSO
Suffix:
Gender:F
Credentials:RPH, FASCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:248 SEANOR RD
Mailing Address - Street 2:
Mailing Address - City:IRWIN
Mailing Address - State:PA
Mailing Address - Zip Code:15642-5706
Mailing Address - Country:US
Mailing Address - Phone:724-744-3053
Mailing Address - Fax:
Practice Address - Street 1:123 BRUBAKER RD
Practice Address - Street 2:
Practice Address - City:BROCKWAY
Practice Address - State:PA
Practice Address - Zip Code:15824-2505
Practice Address - Country:US
Practice Address - Phone:814-503-7400
Practice Address - Fax:814-503-7170
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP042650L1835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric