Provider Demographics
NPI:1215390893
Name:PALADINI, ERICA JORDAN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:JORDAN
Last Name:PALADINI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:ERICA
Other - Middle Name:MARIE
Other - Last Name:JORDAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:78 STANHOPE RD
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-2257
Mailing Address - Country:US
Mailing Address - Phone:973-670-1589
Mailing Address - Fax:
Practice Address - Street 1:174 EDISON RD
Practice Address - Street 2:
Practice Address - City:LAKE HOPATCONG
Practice Address - State:NJ
Practice Address - Zip Code:07849-2217
Practice Address - Country:US
Practice Address - Phone:973-663-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-01
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00389400363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant