Provider Demographics
NPI:1487881512
Name:PAWLUKOVICH, JENNIFER JONES (PHARMD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JONES
Last Name:PAWLUKOVICH
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 1:2970 NIAGARA FALLS BLVD
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228
Mailing Address - Country:US
Mailing Address - Phone:716-692-3704
Mailing Address - Fax:
Practice Address - Street 1:2970 NIAGARA FALLS BLVD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228
Practice Address - Country:US
Practice Address - Phone:716-692-3704
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-16
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049382183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist