Provider Demographics
NPI:1659697175
Name:DELEONARDIS, JENNIFER JOAN (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:JOAN
Last Name:DELEONARDIS
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 1:259 BULL HILL LANE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CT
Mailing Address - Zip Code:06477
Mailing Address - Country:US
Mailing Address - Phone:203-795-0634
Mailing Address - Fax:203-795-0640
Practice Address - Street 1:259 BULL HILL LANE, SNOPNTE PHARMACY
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CT
Practice Address - Zip Code:06477
Practice Address - Country:US
Practice Address - Phone:203-795-0634
Practice Address - Fax:203-795-0640
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-08
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT0009738183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist