Provider Demographics
NPI:1285755462
Name:RIZVI, ERUM (BS(PHARM))
Entity type:Individual
Prefix:
First Name:ERUM
Middle Name:
Last Name:RIZVI
Suffix:
Gender:F
Credentials:BS(PHARM)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 PINEO FARMS RD
Mailing Address - Street 2:
Mailing Address - City:SEABROOK
Mailing Address - State:NH
Mailing Address - Zip Code:03874-4197
Mailing Address - Country:US
Mailing Address - Phone:617-616-7961
Mailing Address - Fax:617-616-7961
Practice Address - Street 1:69 PORTSMOUTH AVE
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-2105
Practice Address - Country:US
Practice Address - Phone:603-778-0553
Practice Address - Fax:603-778-2587
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3411183500000X
TX44859183500000X
MEPR5400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist