Provider Demographics
NPI:1184827115
Name:DEMRY, ERIC (DAC, MPH, LAC, RDN)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:
Last Name:DEMRY
Suffix:
Gender:M
Credentials:DAC, MPH, LAC, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 E 124TH ST APT 4C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035-2001
Mailing Address - Country:US
Mailing Address - Phone:212-837-8071
Mailing Address - Fax:
Practice Address - Street 1:205 E 124TH ST APT 4C
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035
Practice Address - Country:US
Practice Address - Phone:212-837-8071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN007102133V00000X
NY1085359133V00000X
NY174H00000X, 251K00000X
NY12211225700000X
NY002404171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No174H00000XOther Service ProvidersHealth Educator
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No251K00000XAgenciesPublic Health or Welfare