Provider Demographics
NPI:1811228505
Name:CHIRICO, JENEANE A (RPH)
Entity Type:Individual
Prefix:MRS
First Name:JENEANE
Middle Name:A
Last Name:CHIRICO
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 1:831 ANNADALE RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-3133
Mailing Address - Country:US
Mailing Address - Phone:718-227-0710
Mailing Address - Fax:718-227-0714
Practice Address - Street 1:831 ANNADALE RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312-3133
Practice Address - Country:US
Practice Address - Phone:718-227-0710
Practice Address - Fax:718-227-0714
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038739-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist