Provider Demographics
NPI:1548608953
Name:HERRMAN, JACQUELINE MARIE
Entity type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:MARIE
Last Name:HERRMAN
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 1:555 HUBBARD AVE STE 19
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-3981
Mailing Address - Country:US
Mailing Address - Phone:413-442-2241
Mailing Address - Fax:413-442-2831
Practice Address - Street 1:555 HUBBARD AVE STE 19
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-3981
Practice Address - Country:US
Practice Address - Phone:413-442-2241
Practice Address - Fax:413-442-2831
Is Sole Proprietor?:No
Enumeration Date:2013-06-07
Last Update Date:2025-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA27458183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist