Provider Demographics
NPI:1194047498
Name:LINK, JESSICA MARIE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:MARIE
Last Name:LINK
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 1:6 JANE LACEY DR APT D
Mailing Address - Street 2:
Mailing Address - City:ENDICOTT
Mailing Address - State:NY
Mailing Address - Zip Code:13760-3714
Mailing Address - Country:US
Mailing Address - Phone:607-206-2252
Mailing Address - Fax:
Practice Address - Street 1:412 DAY HOLLOW RD
Practice Address - Street 2:
Practice Address - City:ENDICOTT
Practice Address - State:NY
Practice Address - Zip Code:13760-2050
Practice Address - Country:US
Practice Address - Phone:607-785-1756
Practice Address - Fax:607-748-0683
Is Sole Proprietor?:No
Enumeration Date:2010-02-28
Last Update Date:2011-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053520183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist