Provider Demographics
NPI:1598127722
Name:SUGAR, JESSI (PHARMD)
Entity Type:Individual
Prefix:
First Name:JESSI
Middle Name:
Last Name:SUGAR
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 ROUTE 94
Mailing Address - Street 2:
Mailing Address - City:BLAIRSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07825
Mailing Address - Country:US
Mailing Address - Phone:908-362-1799
Mailing Address - Fax:203-250-2256
Practice Address - Street 1:152 ROUTE 94
Practice Address - Street 2:
Practice Address - City:BLAIRSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07825
Practice Address - Country:US
Practice Address - Phone:903-362-1799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-26
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0013253183500000X
NJ28RI03842100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist