Provider Demographics
NPI:1609058650
Name:BYRNE, JENNIFER (RPH)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:BYRNE
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:PO BOX 246
Mailing Address - Street 2:
Mailing Address - City:HAINES FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12436-0246
Mailing Address - Country:US
Mailing Address - Phone:518-589-5620
Mailing Address - Fax:
Practice Address - Street 1:19 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CATSKILL
Practice Address - State:NY
Practice Address - Zip Code:12414-1746
Practice Address - Country:US
Practice Address - Phone:518-943-4182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-01
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044441183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist