Provider Demographics
NPI:1255742128
Name:SUNUKJIAN, JENNIFER SUE (RPH)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:SUE
Last Name:SUNUKJIAN
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 1:7550 COURT ST
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:12932
Mailing Address - Country:US
Mailing Address - Phone:518-873-6441
Mailing Address - Fax:518-873-9535
Practice Address - Street 1:7550 COURT STREET
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:NY
Practice Address - Zip Code:12932
Practice Address - Country:US
Practice Address - Phone:518-873-6441
Practice Address - Fax:518-873-9535
Is Sole Proprietor?:No
Enumeration Date:2014-05-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048092-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist