Provider Demographics
NPI:1003374331
Name:MCGREEVY, JENNA LYNNE (PHARMD)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:LYNNE
Last Name:MCGREEVY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 DEER RUN DR
Mailing Address - Street 2:
Mailing Address - City:BALLSTON SPA
Mailing Address - State:NY
Mailing Address - Zip Code:12020-4608
Mailing Address - Country:US
Mailing Address - Phone:518-524-0046
Mailing Address - Fax:
Practice Address - Street 1:101 RIDGE ST
Practice Address - Street 2:
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-3624
Practice Address - Country:US
Practice Address - Phone:518-798-6066
Practice Address - Fax:518-761-2097
Is Sole Proprietor?:No
Enumeration Date:2019-03-05
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY063019183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist