CASANDRA BONITA JETER (NPI# 1336453521) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336453521 |
| Entity Type | Individual |
| Full Name | CASANDRA BONITA JETER |
| Credential | RPH |
| Practice Address |
2201 W Allegheny Ave Philadelphia PA 19132-1420 |
| Practice Telephone | 2152238979 |
| Practice Fax Number | 2152270932 |
| Mailing Telephone | 2152238979 |
| Mailing Fax Number | 2152270932 |
| Enumeration Date | 2010-07-30 |
| Last Update Date | 2010-07-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
RP029008L | PA | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | NPI | 1679663793 | 01 |
| Street Address |
2201 W ALLEGHENY AVE |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19132-1420 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134608847 | Stanley Yu | Pharmacist | 2201 W Allegheny Ave, Philadelphia, PA 19132-1420 | 2018-08-13 |
| 1275948960 | Tibebu Nigibo | Pharmacist | 2201 W Allegheny Ave, Philadelphia, PA 19132-1420 | 2014-06-22 |
| 1114330149 | Ajay Peter | Pharmacist | 2201 W Allegheny Ave, Philadelphia, PA 19132-1420 | 2014-06-06 |
| 1720392400 | Y Nhu Dang | Pharmacist | 2201 W Allegheny Ave, Philadelphia, PA 19132-1420 | 2010-08-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811511017 | Irene Maria Clark | Social Worker | 3101 N. 29th St., Philadelphia, PA 19132 | 2020-06-03 |
| 1518407519 | Forget Me Knot Youth Services | Residential Treatment Facility, Emotionally Disturbed Children | 2321 N Broad Street, Philadelphia, PA 19132 | 2017-02-24 |
| 1609322437 | Shaakira Gillette | Social Worker | 2514 N. Broad St, Philadelphia, PA 19132 | 2016-08-31 |
| 1578017042 | Education Plus, Inc. | Nurse Practitioner | 3217 W. Clearfield Street, Philadelphia, PA 19132 | 2016-08-12 |
| 1972958544 | Rittenhouse Health LLC | Substance Abuse Rehabilitation Facility | 2321 N. Broad St, Philadelphia, PA 19132 | 2016-05-02 |
| 1336593458 | Jamal Vann | Counselor | 2233-43 West Allegheny Avenue, Philadelphia, PA 19132 | 2016-04-14 |
| 1487027132 | Jazzmin Devine | Specialist/Technologist | 200 Prospect St Hemlock 430a, East Stroudsburg University, PA 19132 | 2015-11-03 |
| 1609282508 | Lawrence Petitfrere | Pharmacist | 2801 W Dauphin St, Philadelphia, PA 19132 | 2014-07-11 |
| 1437565157 | Mental Health Partnerships | Community/Behavioral Health | 2709 N. Broad Street, Philadelphia, PA 19132 | 2014-07-02 |
| 1477977346 | Randy Morman | Counselor | 2514 N. Broad Street, 1st Floor, Philadelphia, PA 19132 | 2014-02-12 |
| Find all providers in zip 19132 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295355030 | Nur Kazzaz | Pharmacist | 3401 N Broad St Ste B150, Philadelphia, PA 19140-5103 | 2020-04-22 |
| 1164903381 | Suzanne Scott Giyanani | Pharmacist | 200 W Washington Sq Apt 3609, Philadelphia, PA 19106-3538 | 2018-08-25 |
| 1629412713 | Rath Hean | Pharmacist | 2131 N Broad St, Philadelphia, PA 19122-1105 | 2013-04-19 |
| 1992010540 | Wayne S Binder | Pharmacist | 9920 Bustleton Ave., Philadelphia, PA 19115 | 2010-08-06 |
| 1689993784 | Alina Kandov | Pharmacist | 9920 Bustleton Avenue, Philadelphia, PA 19115-1006 | 2010-05-28 |
| 1700483120 | James Joseph Cavage II | Pharmacist | 200 Stevens Dr, Philadelphia, PA 19113-1532 | 2020-10-08 |
| 1376165407 | Jenny Au | Pharmacist | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2020-05-12 |
| 1043831480 | Alasan Jallow | Pharmacist | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2020-04-27 |
| 1477190288 | Sherin Abu | Pharmacist | 12311 Academy Rd, Philadelphia, PA 19154-1927 | 2019-12-01 |
| 1386295525 | Divya Lal | Pharmacist | 338 E Allegheny Ave, Philadelphia, PA 19134-2321 | 2019-09-27 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19132 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.