Provider Demographics
NPI:1013397470
Name:LAGE, ERIN (BS)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:LAGE
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:
Other - Last Name:RINGBLOOM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4 RESEARCH DR STE 402
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-6242
Mailing Address - Country:US
Mailing Address - Phone:203-242-3146
Mailing Address - Fax:
Practice Address - Street 1:402 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06702-1701
Practice Address - Country:US
Practice Address - Phone:203-755-1143
Practice Address - Fax:203-753-3274
Is Sole Proprietor?:No
Enumeration Date:2015-06-01
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator