Provider Demographics
NPI:1225586944
Name:MCKEE, EMILY
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:MCKEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 GRASMERE AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-6102
Mailing Address - Country:US
Mailing Address - Phone:203-255-0060
Mailing Address - Fax:
Practice Address - Street 1:330 GRASMERE AVE
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-6102
Practice Address - Country:US
Practice Address - Phone:203-255-0060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-12
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT13839183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist