Provider Demographics
NPI:1093320145
Name:HIGGINS, ERIN MIRA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:MIRA
Last Name:HIGGINS
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 1:126 JERICHO TPKE
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-3018
Mailing Address - Country:US
Mailing Address - Phone:631-543-0079
Mailing Address - Fax:
Practice Address - Street 1:126 JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-3018
Practice Address - Country:US
Practice Address - Phone:631-543-0079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-14
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYI066909183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist