Provider Demographics
NPI:1275751083
Name:CHEESMAN, ERICA LYNN (RPH)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:LYNN
Last Name:CHEESMAN
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 1:5722 DUNBAR CT
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-2217
Mailing Address - Country:US
Mailing Address - Phone:267-852-0262
Mailing Address - Fax:
Practice Address - Street 1:2301 BRISTOL RD
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-6000
Practice Address - Country:US
Practice Address - Phone:215-741-9775
Practice Address - Fax:215-741-9777
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP045693L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist