Provider Demographics
NPI:1083686406
Name:ERBA, ANNALISA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ANNALISA
Middle Name:
Last Name:ERBA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 W 10TH ST APT 13
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-3152
Mailing Address - Country:US
Mailing Address - Phone:212-920-0350
Mailing Address - Fax:
Practice Address - Street 1:920 BROADWAY
Practice Address - Street 2:8TH FLOOR, SUITE 1
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-6004
Practice Address - Country:US
Practice Address - Phone:212-920-0350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016114103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYVN0951Medicare ID - Type Unspecified