Provider Demographics
NPI:1740008051
Name:ROBERTS, ERIN
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1241 BLAKESLEE BOULEVARD DR E STE 2
Mailing Address - Street 2:
Mailing Address - City:LEHIGHTON
Mailing Address - State:PA
Mailing Address - Zip Code:18235-2401
Mailing Address - Country:US
Mailing Address - Phone:570-386-5838
Mailing Address - Fax:
Practice Address - Street 1:1241 BLAKESLEE BOULEVARD DR E STE 2
Practice Address - Street 2:
Practice Address - City:LEHIGHTON
Practice Address - State:PA
Practice Address - Zip Code:18235-2401
Practice Address - Country:US
Practice Address - Phone:570-386-5838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-26
Last Update Date:2025-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP458913183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARPI017092OtherPENNSYLVANIA PHARMACIST IMMUNIZATION LICENSE
PARP458913OtherPENNSYLVANIA PHARMACIST LICENSE