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Individual

JEANNIE S JOO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
118 BROAD AVE, SUITE N4, PALISADES PARK, NJ 07650-2717
(201) 945-7222
(201) 945-7222
Mailing address
118 BROAD AVE, SUITE N4, PALISADES PARK, NJ 07650-2717
(201) 945-7222
(201) 945-7222

Taxonomy

Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
28RJ00612
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
28RJ00612
LICENSE
NJ
01
28RS00398200
LICENSE
NJ
Enumeration date
07/08/2013
Last updated
07/08/2013
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