Provider Demographics
NPI:1407063688
Name:KLEIN, DARCEY MARIE (BS PHARMACY)
Entity Type:Individual
Prefix:MS
First Name:DARCEY
Middle Name:MARIE
Last Name:KLEIN
Suffix:
Gender:F
Credentials:BS PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:NH
Mailing Address - Zip Code:03033-2492
Mailing Address - Country:US
Mailing Address - Phone:603-673-6206
Mailing Address - Fax:
Practice Address - Street 1:15 MONT VERNON ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:NH
Practice Address - Zip Code:03055-4120
Practice Address - Country:US
Practice Address - Phone:603-673-0224
Practice Address - Fax:603-673-7644
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHR1552183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist