Provider Demographics
NPI:1760756324
Name:MCAULEY, KYM MARGARET (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KYM
Middle Name:MARGARET
Last Name:MCAULEY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 BUTTERNUT WAY
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-3473
Mailing Address - Country:US
Mailing Address - Phone:973-209-1122
Mailing Address - Fax:
Practice Address - Street 1:90 US HIGHWAY 206 STE 80
Practice Address - Street 2:
Practice Address - City:STANHOPE
Practice Address - State:NJ
Practice Address - Zip Code:07874-3128
Practice Address - Country:US
Practice Address - Phone:973-448-1232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-29
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03110200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist