Provider Demographics
NPI:1023330347
Name:MCKEEGAN, JOSEPH LAWRENCE (PHARMACIST)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:LAWRENCE
Last Name:MCKEEGAN
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:488 STATE ROUTE 17M
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-4124
Mailing Address - Country:US
Mailing Address - Phone:845-783-7807
Mailing Address - Fax:845-783-0816
Practice Address - Street 1:488 STATE ROUTE 17M
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-4124
Practice Address - Country:US
Practice Address - Phone:845-783-7807
Practice Address - Fax:845-783-0816
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-01
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY27273183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist