Provider Demographics
NPI:1417046186
Name:GLAZER, ERICA (NP)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:GLAZER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:592 ROUTE 22 STE 1B
Mailing Address - Street 2:
Mailing Address - City:PAWLING
Mailing Address - State:NY
Mailing Address - Zip Code:12564-1257
Mailing Address - Country:US
Mailing Address - Phone:845-493-0274
Mailing Address - Fax:845-493-0279
Practice Address - Street 1:592 ROUTE 22 STE 1B
Practice Address - Street 2:
Practice Address - City:PAWLING
Practice Address - State:NY
Practice Address - Zip Code:12564-1257
Practice Address - Country:US
Practice Address - Phone:845-493-0274
Practice Address - Fax:845-493-0279
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF333090363L00000X
CT12555363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily