Provider Demographics
NPI:1457401846
Name:MCCLOY, KRISTEN (PHARMD)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:MCCLOY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:463 N WHITE HORSE PIKE
Mailing Address - Street 2:
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-1881
Mailing Address - Country:US
Mailing Address - Phone:609-567-2241
Mailing Address - Fax:609-561-9444
Practice Address - Street 1:463 N WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-1881
Practice Address - Country:US
Practice Address - Phone:609-567-2241
Practice Address - Fax:609-561-9444
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2009-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02949000183500000X
PARP439838183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist