Provider Demographics
NPI:1295057685
Name:ESTIME, JEAN D (RPH)
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:D
Last Name:ESTIME
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5439 100TH ST
Mailing Address - Street 2:701
Mailing Address - City:CORONA
Mailing Address - State:NY
Mailing Address - Zip Code:11368-3782
Mailing Address - Country:US
Mailing Address - Phone:917-459-2404
Mailing Address - Fax:
Practice Address - Street 1:440 9TH AVE
Practice Address - Street 2:9TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-1620
Practice Address - Country:US
Practice Address - Phone:212-356-5280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-25
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047889183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist