Provider Demographics
NPI:1770179103
Name:SZAMBOTI, JESSICA ROSE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:ROSE
Last Name:SZAMBOTI
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 1:2550 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114-2227
Mailing Address - Country:US
Mailing Address - Phone:215-464-8140
Mailing Address - Fax:215-464-8183
Practice Address - Street 1:2550 GRANT AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-2227
Practice Address - Country:US
Practice Address - Phone:215-464-8140
Practice Address - Fax:215-464-8183
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-20
Last Update Date:2020-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP446591183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist