Healthcare Provider Details
I. General information
NPI: 1811331531
Provider Name (Legal Business Name): ERICA E MOLARO PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/24/2013
Last Update Date: 04/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
RELIEVUS 9815 ROSSEVELT BLVD UNIT J
PHILADELPHIA PA
19114
US
IV. Provider business mailing address
PO BOX 7776
LANCASTER PA
17601
US
V. Phone/Fax
- Phone: 888-985-2727
- Fax: 609-567-8832
- Phone: 888-985-2727
- Fax: 856-779-0211
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | MA057561 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: