Provider Demographics
NPI:1053599225
Name:KERINS, MAUREEN ANN (RPH)
Entity type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:ANN
Last Name:KERINS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 PIDGEON HILL RD
Mailing Address - Street 2:
Mailing Address - City:SUSSEX
Mailing Address - State:NJ
Mailing Address - Zip Code:07461-2731
Mailing Address - Country:US
Mailing Address - Phone:973-600-8944
Mailing Address - Fax:
Practice Address - Street 1:10 A RTE 23 NORTH
Practice Address - Street 2:
Practice Address - City:MONTAGUE
Practice Address - State:NJ
Practice Address - Zip Code:07827-9807
Practice Address - Country:US
Practice Address - Phone:973-293-3273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-09
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02274400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist