Basic Information
Provider Information
NPI: 1619315363
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DRURY
FirstName: ERIKA
MiddleName: R.
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 601 ELMWOOD AVENUE BOX 675
Address2:  
City: ROCHESTER
State: NY
PostalCode: 146420001
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 601 ELMWOOD AVE
Address2:  
City: ROCHESTER
State: NY
PostalCode: 146425400
CountryCode: US
TelephoneNumber: 5852754517
FaxNumber: 5854429201
Other Information
ProviderEnumerationDate: 06/04/2013
LastUpdateDate: 06/17/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RN0300X298044NYY Allopathic & Osteopathic PhysiciansInternal MedicineNephrology

No ID Information.


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