Provider Demographics
NPI:1295189389
Name:MESSIER, KEVIN M (PHARM D)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:M
Last Name:MESSIER
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 MONTAUK AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:NEW LONDON
Mailing Address - State:CT
Mailing Address - Zip Code:06320-4906
Mailing Address - Country:US
Mailing Address - Phone:860-447-9145
Mailing Address - Fax:860-271-8419
Practice Address - Street 1:21 MONTAUK AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:NEW LONDON
Practice Address - State:CT
Practice Address - Zip Code:06320-4906
Practice Address - Country:US
Practice Address - Phone:860-447-9145
Practice Address - Fax:860-271-8419
Is Sole Proprietor?:No
Enumeration Date:2016-04-15
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0012170183500000X
RIRPH04448183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist