Provider Demographics
NPI:1164141339
Name:PADRON PERNIA, ERIKA GRACIELA (MS)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:GRACIELA
Last Name:PADRON PERNIA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 DESSIE HTS
Mailing Address - Street 2:
Mailing Address - City:WEST HENRIETTA
Mailing Address - State:NY
Mailing Address - Zip Code:14586-9548
Mailing Address - Country:US
Mailing Address - Phone:718-808-3997
Mailing Address - Fax:
Practice Address - Street 1:2825 3RD AVE STE 402
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10455-4066
Practice Address - Country:US
Practice Address - Phone:718-520-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health