Provider Demographics
NPI:1366855181
Name:YEE, KIMBERLY A
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:A
Last Name:YEE
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 1:100 DERBY ST
Mailing Address - Street 2:STE 505
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043-4210
Mailing Address - Country:US
Mailing Address - Phone:781-749-8730
Mailing Address - Fax:781-749-2356
Practice Address - Street 1:100 DERBY ST
Practice Address - Street 2:STE 505
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043-4210
Practice Address - Country:US
Practice Address - Phone:781-749-8730
Practice Address - Fax:781-749-2356
Is Sole Proprietor?:No
Enumeration Date:2014-06-10
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH234786183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist