Healthcare Provider Details

I. General information

NPI: 1366855181
Provider Name (Legal Business Name): KIMBERLY A YEE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2014
Last Update Date: 06/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 DERBY ST STE 505
HINGHAM MA
02043-4210
US

IV. Provider business mailing address

100 DERBY ST STE 505
HINGHAM MA
02043-4210
US

V. Phone/Fax

Practice location:
  • Phone: 781-749-8730
  • Fax: 781-749-2356
Mailing address:
  • Phone: 781-749-8730
  • Fax: 781-749-2356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH234786
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: