Provider Demographics
NPI:1780985374
Name:CAGGIANO, JENNIFER M (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:M
Last Name:CAGGIANO
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 1:1503 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HONESDALE
Mailing Address - State:PA
Mailing Address - Zip Code:18431-2007
Mailing Address - Country:US
Mailing Address - Phone:470-470-0820
Mailing Address - Fax:
Practice Address - Street 1:722 ROUTE 6 AND 209
Practice Address - Street 2:
Practice Address - City:MATAMORAS
Practice Address - State:PA
Practice Address - Zip Code:18336
Practice Address - Country:US
Practice Address - Phone:570-491-5019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-12
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP444817183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist