Provider Demographics
NPI:1306161336
Name:MARRAFFA, JEANNA M (PHARMD DABAT)
Entity type:Individual
Prefix:
First Name:JEANNA
Middle Name:M
Last Name:MARRAFFA
Suffix:
Gender:F
Credentials:PHARMD DABAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1237 GREENVIEW DR
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13501-4111
Mailing Address - Country:US
Mailing Address - Phone:315-464-7076
Mailing Address - Fax:
Practice Address - Street 1:250 HARRISON ST
Practice Address - Street 2:UPSTATE NY POISON CENTER
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202
Practice Address - Country:US
Practice Address - Phone:315-464-7076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-01
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0480751835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist