Provider Demographics
NPI:1386923795
Name:DURANT, ERICA RACHELLE (PHARMD, RPH)
Entity type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:RACHELLE
Last Name:DURANT
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:RACHELLE
Other - Last Name:FISHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5942 S SALINA ST
Mailing Address - Street 2:RA10755
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13205-3326
Mailing Address - Country:US
Mailing Address - Phone:315-469-3254
Mailing Address - Fax:
Practice Address - Street 1:5942 S SALINA ST
Practice Address - Street 2:RA10755
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13205-3326
Practice Address - Country:US
Practice Address - Phone:315-469-3254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-16
Last Update Date:2013-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY055924183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist