Provider Demographics
NPI:1417279373
Name:CAREY, ANITA M
Entity Type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:M
Last Name:CAREY
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 1:9 PLAZA WAY
Mailing Address - Street 2:
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-4601
Mailing Address - Country:US
Mailing Address - Phone:508-990-1072
Mailing Address - Fax:508-984-4475
Practice Address - Street 1:9 PLAZA WAY
Practice Address - Street 2:
Practice Address - City:FAIRHAVEN
Practice Address - State:MA
Practice Address - Zip Code:02719-4601
Practice Address - Country:US
Practice Address - Phone:508-990-1072
Practice Address - Fax:508-984-4475
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-19
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH23114183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist