Provider Demographics
NPI:1265986657
Name:SAVVA, JACQUELINE (PHARMD, BCPS)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:
Last Name:SAVVA
Suffix:
Gender:F
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:JACQUELINE
Other - Middle Name:
Other - Last Name:CHIRICO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD, BCPS
Mailing Address - Street 1:114 BURTON AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10309-3550
Mailing Address - Country:US
Mailing Address - Phone:917-327-4489
Mailing Address - Fax:
Practice Address - Street 1:3415 BAINBRIDGE AVE DEPT OF
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2403
Practice Address - Country:US
Practice Address - Phone:718-741-2645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-15
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP451042183500000X
NY061841183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist