Provider Demographics
NPI:1790023638
Name:JANNETTA, ERIN (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:
Last Name:JANNETTA
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 BASKET RD
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-9753
Mailing Address - Country:US
Mailing Address - Phone:585-278-2180
Mailing Address - Fax:
Practice Address - Street 1:221 BASKET RD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-9753
Practice Address - Country:US
Practice Address - Phone:585-278-2180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-28
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY055850183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist