Provider Demographics
NPI:1730848714
Name:RICHARD, DANIQUE (PHARMD)
Entity type:Individual
Prefix:
First Name:DANIQUE
Middle Name:
Last Name:RICHARD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:DANIQUE
Other - Middle Name:
Other - Last Name:RICHARD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1401 FOUCHER ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-3515
Mailing Address - Country:US
Mailing Address - Phone:504-758-3726
Mailing Address - Fax:
Practice Address - Street 1:1401 FOUCHER ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3515
Practice Address - Country:US
Practice Address - Phone:504-758-3726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-17
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.024142183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist