Provider Demographics
NPI:1013149228
Name:BUCKLEY, SEAN TIMOTHY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:TIMOTHY
Last Name:BUCKLEY
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 1:40C STONEHOUSE LN
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-5253
Mailing Address - Country:US
Mailing Address - Phone:603-391-7937
Mailing Address - Fax:
Practice Address - Street 1:440 WEST ST
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-2453
Practice Address - Country:US
Practice Address - Phone:603-357-1002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-20
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3626183500000X
VT033-0055647183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist