Provider Demographics
NPI:1609205921
Name:BAKER, ERICA (PHARMD)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:
Other - Last Name:ATKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:75 FRESHWATER BLVD
Mailing Address - Street 2:
Mailing Address - City:ENFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06082-3854
Mailing Address - Country:US
Mailing Address - Phone:860-394-2028
Mailing Address - Fax:
Practice Address - Street 1:75 FRESHWATER BLVD
Practice Address - Street 2:
Practice Address - City:ENFIELD
Practice Address - State:CT
Practice Address - Zip Code:06082-3854
Practice Address - Country:US
Practice Address - Phone:860-394-2028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-06
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT10663183500000X
DE3447183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist