Provider Demographics
NPI:1720807217
Name:MOKAN, MARGARET
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:MOKAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 SABRINA BROOKE LN
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-4385
Mailing Address - Country:US
Mailing Address - Phone:413-579-7105
Mailing Address - Fax:
Practice Address - Street 1:100 QUALITY ST
Practice Address - Street 2:
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-3143
Practice Address - Country:US
Practice Address - Phone:203-261-3691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH1000966183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist