Provider Demographics
NPI:1851994362
Name:SON, MEE SO (PHARM D)
Entity Type:Individual
Prefix:
First Name:MEE SO
Middle Name:
Last Name:SON
Suffix:
Gender:F
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 1:188 CEDAR LN
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-4302
Mailing Address - Country:US
Mailing Address - Phone:201-287-4441
Mailing Address - Fax:
Practice Address - Street 1:188 CEDAR LN
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4302
Practice Address - Country:US
Practice Address - Phone:201-287-4441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY060438183500000X
NJ28RI03495500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist