Provider Demographics
NPI:1114951720
Name:LARSEN, ERIK A (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIK
Middle Name:A
Last Name:LARSEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 DEPOT PL
Mailing Address - Street 2:
Mailing Address - City:NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960-4401
Mailing Address - Country:US
Mailing Address - Phone:845-353-0174
Mailing Address - Fax:
Practice Address - Street 1:WHITE PLAINS HOSPITAL
Practice Address - Street 2:DAVIS AVENUE AT EAST POST ROAD
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601
Practice Address - Country:US
Practice Address - Phone:914-681-1158
Practice Address - Fax:914-681-2878
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174723207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
18L851Medicare ID - Type Unspecified
NYF44454Medicare UPIN