Provider Demographics
NPI:1407168057
Name:PIETRUCHA, ERIKA (MSED)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:PIETRUCHA
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:248 13TH ST STE 203
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-4802
Mailing Address - Country:US
Mailing Address - Phone:718-788-5101
Mailing Address - Fax:
Practice Address - Street 1:248 13TH ST
Practice Address - Street 2:SUITE 203
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-4802
Practice Address - Country:US
Practice Address - Phone:718-788-5101
Practice Address - Fax:718-788-8274
Is Sole Proprietor?:No
Enumeration Date:2010-07-12
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health