Provider Demographics
NPI:1346530615
Name:LOPEZ, ERIK M (PHARMD)
Entity type:Individual
Prefix:
First Name:ERIK
Middle Name:M
Last Name:LOPEZ
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:289 GREENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BETHEL
Mailing Address - State:CT
Mailing Address - Zip Code:06801-2402
Mailing Address - Country:US
Mailing Address - Phone:203-792-6199
Mailing Address - Fax:
Practice Address - Street 1:289 GREENWOOD AVE
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:CT
Practice Address - Zip Code:06801-2402
Practice Address - Country:US
Practice Address - Phone:203-792-6190
Practice Address - Fax:203-748-7464
Is Sole Proprietor?:No
Enumeration Date:2011-04-07
Last Update Date:2023-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS63652183500000X
CTPCT.0011654183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist