Provider Demographics
NPI:1982298931
Name:BECKER, NICOLE CHRISTINE (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:CHRISTINE
Last Name:BECKER
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 1:100 ALBERT DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:NY
Mailing Address - Zip Code:14086-2804
Mailing Address - Country:US
Mailing Address - Phone:716-225-8552
Mailing Address - Fax:
Practice Address - Street 1:2348 ROUTE 19 N
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:NY
Practice Address - Zip Code:14569-9356
Practice Address - Country:US
Practice Address - Phone:585-786-0880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-21
Last Update Date:2022-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY067411183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist