Provider Demographics
NPI:1700423910
Name:SMOLA, JENNIFER MARIE ANNA (PHARMD, BCPS)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:MARIE ANNA
Last Name:SMOLA
Suffix:
Gender:F
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 MEDICAL CENTER DR STE 204
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01107-1271
Mailing Address - Country:US
Mailing Address - Phone:413-794-6436
Mailing Address - Fax:413-794-6421
Practice Address - Street 1:2 MEDICAL CENTER DR STE 204
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1271
Practice Address - Country:US
Practice Address - Phone:413-794-6436
Practice Address - Fax:413-794-6421
Is Sole Proprietor?:No
Enumeration Date:2019-12-06
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH234213183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist