Provider Demographics
NPI:1568732964
Name:GENTILE, ERICA M (MSED)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:M
Last Name:GENTILE
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 1:77 CHELSEA DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT SINAI
Mailing Address - State:NY
Mailing Address - Zip Code:11766-2711
Mailing Address - Country:US
Mailing Address - Phone:631-928-9182
Mailing Address - Fax:
Practice Address - Street 1:77 CHELSEA DR
Practice Address - Street 2:
Practice Address - City:MOUNT SINAI
Practice Address - State:NY
Practice Address - Zip Code:11766-2711
Practice Address - Country:US
Practice Address - Phone:631-928-9182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-03
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist