Provider Demographics
NPI:1053595314
Name:ALBANO, JENNIFER
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:ALBANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:871 SAW MILL RIVER RD
Mailing Address - Street 2:
Mailing Address - City:ARDSLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10502-1116
Mailing Address - Country:US
Mailing Address - Phone:914-693-6455
Mailing Address - Fax:914-693-6953
Practice Address - Street 1:871 SAW MILL RIVET ROAD
Practice Address - Street 2:
Practice Address - City:ARDSLEY
Practice Address - State:NY
Practice Address - Zip Code:10502-1116
Practice Address - Country:US
Practice Address - Phone:914-693-6455
Practice Address - Fax:914-693-6953
Is Sole Proprietor?:No
Enumeration Date:2007-12-21
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051547183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist