Provider Demographics
NPI:1902502131
Name:CRAFFEY, KEITH P (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KEITH
Middle Name:P
Last Name:CRAFFEY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 ROCKY HILL RD
Mailing Address - Street 2:
Mailing Address - City:REHOBOTH
Mailing Address - State:MA
Mailing Address - Zip Code:02769-1415
Mailing Address - Country:US
Mailing Address - Phone:401-297-7743
Mailing Address - Fax:
Practice Address - Street 1:415 E FALMOUTH HWY
Practice Address - Street 2:
Practice Address - City:EAST FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02536-6166
Practice Address - Country:US
Practice Address - Phone:302-422-3341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-31
Last Update Date:2025-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0015556183500000X
MAPH25924183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEA1-0015556OtherPHARMACIST LICENSE
MAPH25924OtherPHARMACIST LICENSE