Provider Demographics
NPI:1124489448
Name:GUARDINO, JENNIFER
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:GUARDINO
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 1:558 LAKEHURST RD UNIT JK
Mailing Address - Street 2:
Mailing Address - City:BROWNS MILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:08015-6060
Mailing Address - Country:US
Mailing Address - Phone:609-893-4700
Mailing Address - Fax:609-893-7380
Practice Address - Street 1:558 LAKEHURST RD
Practice Address - Street 2:
Practice Address - City:BROWNS MILLS
Practice Address - State:NJ
Practice Address - Zip Code:08015-6060
Practice Address - Country:US
Practice Address - Phone:609-893-4700
Practice Address - Fax:609-893-7380
Is Sole Proprietor?:No
Enumeration Date:2016-03-14
Last Update Date:2023-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI026772183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist