Provider Demographics
NPI:1326673708
Name:LOPEZ, ERICA NAZARENO (PHARMD)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:NAZARENO
Last Name:LOPEZ
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 1:113 RYANS RUN
Mailing Address - Street 2:
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-3711
Mailing Address - Country:US
Mailing Address - Phone:856-361-5409
Mailing Address - Fax:
Practice Address - Street 1:113 RYANS RUN
Practice Address - Street 2:
Practice Address - City:SICKLERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08081-3711
Practice Address - Country:US
Practice Address - Phone:856-361-5409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-06
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04087600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist