Active NPI
Jennifer Domzalski, PHARMD
- Pharmacist
- Hazle Township, PA
National Provider Identifier
1366052961
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP046175L
- Practice address
- 761 Airport Rd
Hazle Township, PA 18202-3282 - Phone
- (570) 510-4631
- NPI assigned
- Aug 7, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP046175L | PA | Primary |
Addresses
Primary practice location
761 Airport Rd
Hazle Township, PA 18202-3282
Mailing address
1054 Woodberry Dr
Mountain Top, PA 18707-9279
Other practice location 1
133 N Main St
Wilkes Barre, PA 18701-2007
Phone (570) 208-5900
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RP046175L | Other | PA | PHARMACY LICENSE |
| RPI008265 | Other | PA | ADMINISTER INJECTABLES |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Jenniferdomzalski@kings.edu |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP046175L | PA | MD | Pharmacist |
Interoperability endpoints
- jenniferdomzalski@kings.edu
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1596758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596758400000",
"number": "1366052961",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1054 WOODBERRY DR",
"city": "MOUNTAIN TOP",
"state": "PA",
"postal_code": "187079279"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "761 AIRPORT RD",
"city": "HAZLE TOWNSHIP",
"state": "PA",
"postal_code": "182023282",
"telephone_number": "570-510-4631"
}
],
"practiceLocations": [
{
"address_1": "133 N Main St",
"address_purpose": "LOCATION",
"city": "Wilkes Barre",
"state": "PA",
"postal_code": "187012007",
"country_code": "US",
"telephone_number": "570-208-5900",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DOMZALSKI",
"first_name": "JENNIFER",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-08-07",
"last_updated": "2020-08-07",
"certification_date": "2020-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP046175L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACY LICENSE",
"identifier": "RP046175L",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ADMINISTER INJECTABLES",
"identifier": "RPI008265",
"state": "PA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "Jenniferdomzalski@kings.edu",
"affiliation": "N",
"address_1": "133 N Main St",
"city": "Wilkes Barre",
"state": "PA",
"country_code": "US",
"postal_code": "187012007",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Hazle Township, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.