Jacqueline Wasynczuk, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

26027130A Issued in IN

Practice address

901 Walnut St Ste 901
Philadelphia, PA 19107-5224

Phone

(765) 413-7801

NPI assigned

Feb 13, 2023

Last updated

Feb 13, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1676246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1235836966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 WALNUT ST APT 4D",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191063738",
            "telephone_number": "765-413-7801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 WALNUT ST STE 901",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075224",
            "telephone_number": "765-413-7801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 S 11th St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191074824",
            "country_code": "US",
            "telephone_number": "765-413-7801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WASYNCZUK",
        "first_name": "JACQUELINE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-13",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP453872",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26027130A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth E Wasserman, MD
• Sara Dana Wasserman, M.D.
• Alan Wasserstein, MD
• Sophia Victoria Wasserwald, CRNP
• Emily Kathryn Wassmer, MD
• Elizabeth Wat
• Meguru Watanabe, M.D.
• Mimiko Watanabe
• Tatsuya Watanabe, MD, PHD
• Jessica Watari, DO

• Pharmacist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pharmacist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.