Provider Demographics
NPI:1043827884
Name:CEDERBERG, JENNIFER R (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:R
Last Name:CEDERBERG
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3210 CARLISLE RD
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17315-4536
Mailing Address - Country:US
Mailing Address - Phone:717-292-6665
Mailing Address - Fax:
Practice Address - Street 1:3210 CARLISLE RD
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:PA
Practice Address - Zip Code:17315-4536
Practice Address - Country:US
Practice Address - Phone:717-292-6665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-25
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS61632183500000X
PARP456764183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist