Provider Demographics
NPI:1831414945
Name:DIMARCO, JACQUELINE C (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:C
Last Name:DIMARCO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:JACQUELINE
Other - Middle Name:C
Other - Last Name:DIBBINI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1 JEWELL PL
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-6119
Mailing Address - Country:US
Mailing Address - Phone:914-907-9817
Mailing Address - Fax:
Practice Address - Street 1:785 MAMARONECK AVE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-2523
Practice Address - Country:US
Practice Address - Phone:914-597-2202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-31
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052854183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist