Provider Demographics
NPI:1538887443
Name:MENDEZ, ERIKA MICHELLE (RPH)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:MICHELLE
Last Name:MENDEZ
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 WALNUT ST APT 1
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07102-4748
Mailing Address - Country:US
Mailing Address - Phone:732-374-5026
Mailing Address - Fax:
Practice Address - Street 1:451 BLOOMFIELD AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07107-1866
Practice Address - Country:US
Practice Address - Phone:973-482-1063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04160000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist