Provider Demographics
NPI:1124364195
Name:SELTZER, JENNIFER LYNN (PHARMD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNN
Last Name:SELTZER
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 1:57 ANDYS HILL RD
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:PA
Mailing Address - Zip Code:17814-8212
Mailing Address - Country:US
Mailing Address - Phone:570-204-6494
Mailing Address - Fax:570-389-1622
Practice Address - Street 1:1000 MARKET ST STE 9
Practice Address - Street 2:
Practice Address - City:BLOOMSBURG
Practice Address - State:PA
Practice Address - Zip Code:17815-2601
Practice Address - Country:US
Practice Address - Phone:570-784-9582
Practice Address - Fax:570-389-1622
Is Sole Proprietor?:No
Enumeration Date:2012-12-20
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP442644183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist