Provider Demographics
NPI:1760666812
Name:FARRELL, JESSICA (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:
Last Name:FARRELL
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:106 NEW SCOTLAND AVEUNE
Mailing Address - Street 2:DEPARTMENT OF PHARMACY PRACTICE
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3492
Mailing Address - Country:US
Mailing Address - Phone:518-694-7219
Mailing Address - Fax:518-694-7018
Practice Address - Street 1:106 NEW SCOTLAND AVEUNE
Practice Address - Street 2:DEPARTMENT OF PHARMACY PRACTICE
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3492
Practice Address - Country:US
Practice Address - Phone:518-694-7219
Practice Address - Fax:518-694-7018
Is Sole Proprietor?:No
Enumeration Date:2007-12-26
Last Update Date:2010-02-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ28RI03162900183500000X
NY0532071835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist