Provider Demographics
NPI:1922395284
Name:CHERUNDOLO, JENNIFER N (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:N
Last Name:CHERUNDOLO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:N
Other - Last Name:MCMICKEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:33 MITCHELL AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13903-1642
Mailing Address - Country:US
Mailing Address - Phone:607-352-5950
Mailing Address - Fax:607-352-5951
Practice Address - Street 1:33 MITCHELL AVE STE 108
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13903-1642
Practice Address - Country:US
Practice Address - Phone:607-352-5950
Practice Address - Fax:607-352-5951
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY063812183500000X
PARP445721183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist