Provider Demographics
NPI:1952189789
Name:HAIRFIELD, JEREMY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:
Last Name:HAIRFIELD
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2618 COUNTY ROAD 6
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:NY
Mailing Address - Zip Code:14456-9515
Mailing Address - Country:US
Mailing Address - Phone:315-759-8593
Mailing Address - Fax:
Practice Address - Street 1:4256 JAMES ST
Practice Address - Street 2:
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057-2175
Practice Address - Country:US
Practice Address - Phone:315-437-1599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-21
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202221510183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist