Provider Demographics
NPI:1922381011
Name:GULA, JENNIFER L (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:L
Last Name:GULA
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 1:201 WYOMING AVE
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18704-3501
Mailing Address - Country:US
Mailing Address - Phone:570-283-8267
Mailing Address - Fax:570-283-8290
Practice Address - Street 1:201 WYOMING AVE
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:PA
Practice Address - Zip Code:18704-3501
Practice Address - Country:US
Practice Address - Phone:570-283-8267
Practice Address - Fax:570-283-8290
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-24
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP441784183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist