Provider Demographics
NPI:1659198422
Name:ERA, UMMEH EHSAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:UMMEH
Middle Name:EHSAN
Last Name:ERA
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 1:10 RIVERLEDGE RD
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12534-1418
Mailing Address - Country:US
Mailing Address - Phone:518-267-9200
Mailing Address - Fax:
Practice Address - Street 1:617 WARREN ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-2813
Practice Address - Country:US
Practice Address - Phone:518-828-9469
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071933183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist