Provider Demographics
NPI:1083984256
Name:MEYER, ERICA SUE (RN)
Entity Type:Individual
Prefix:MS
First Name:ERICA
Middle Name:SUE
Last Name:MEYER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:178 E 109TH ST
Mailing Address - Street 2:APT. 4
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-3657
Mailing Address - Country:US
Mailing Address - Phone:678-524-9648
Mailing Address - Fax:
Practice Address - Street 1:178 E 109TH ST
Practice Address - Street 2:APT. 4
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-3657
Practice Address - Country:US
Practice Address - Phone:678-524-9648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-05
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY570961163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn