Provider Demographics
NPI:1669651915
Name:OKEEFE, JENNIFER (RPH)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:OKEEFE
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 1:470 ROUTE 211 E
Mailing Address - Street 2:PHARMACY
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-2245
Mailing Address - Country:US
Mailing Address - Phone:845-342-0381
Mailing Address - Fax:845-342-0387
Practice Address - Street 1:470 ROUTE 211 E
Practice Address - Street 2:PHARMACY
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-2245
Practice Address - Country:US
Practice Address - Phone:845-342-0381
Practice Address - Fax:845-342-0387
Is Sole Proprietor?:No
Enumeration Date:2007-11-02
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047632183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist