Provider Demographics
NPI:1609479591
Name:FICHERA, GERARD FRANCIS
Entity Type:Individual
Prefix:
First Name:GERARD
Middle Name:FRANCIS
Last Name:FICHERA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 SYCAMORE RD
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-7119
Mailing Address - Country:US
Mailing Address - Phone:978-852-7439
Mailing Address - Fax:
Practice Address - Street 1:512 S BROADWAY
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-4306
Practice Address - Country:US
Practice Address - Phone:603-898-5983
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-21
Last Update Date:2020-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2055183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist