Provider Demographics
NPI:1568960722
Name:ERAZO, MONICA (MS)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:ERAZO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 E 77TH STREET
Mailing Address - Street 2:BLACK HALL, 2ND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-1851
Mailing Address - Country:US
Mailing Address - Phone:212-434-6583
Mailing Address - Fax:212-434-2289
Practice Address - Street 1:130 E 77TH STREET
Practice Address - Street 2:BLACK HALL, 2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-1851
Practice Address - Country:US
Practice Address - Phone:212-434-6583
Practice Address - Fax:212-434-2289
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-23
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS