Healthcare Provider Details

I. General information

NPI: 1235399072
Provider Name (Legal Business Name): ERICA LYNN MACEIRA PHARMD, BCPS, CACP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2008
Last Update Date: 03/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43 NEW SCOTLAND AVE MC 85
ALBANY NY
12208-3412
US

IV. Provider business mailing address

11 PROSPECT HILLS RD
RENSSELAER NY
12144-4250
US

V. Phone/Fax

Practice location:
  • Phone: 518-262-2782
  • Fax:
Mailing address:
  • Phone: 518-487-9004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number051748
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: