Provider Demographics
NPI:1801978283
Name:SZALACSI, JACLYN (RPH)
Entity type:Individual
Prefix:MS
First Name:JACLYN
Middle Name:
Last Name:SZALACSI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2215 MURRAY ST
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-3738
Mailing Address - Country:US
Mailing Address - Phone:718-358-1300
Mailing Address - Fax:718-762-7140
Practice Address - Street 1:5737 MAIN ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-5332
Practice Address - Country:US
Practice Address - Phone:718-358-1300
Practice Address - Fax:718-762-7140
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047670183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist