Provider Demographics
NPI:1609358381
Name:POOLE, ERICA LEE (MS, GC)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:LEE
Last Name:POOLE
Suffix:
Gender:F
Credentials:MS, GC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 NORTHERN BLVD STE 100A
Mailing Address - Street 2:
Mailing Address - City:GREENVALE
Mailing Address - State:NY
Mailing Address - Zip Code:11548-1220
Mailing Address - Country:US
Mailing Address - Phone:516-563-7857
Mailing Address - Fax:516-563-7912
Practice Address - Street 1:2200 NORTHERN BLVD STE 100A
Practice Address - Street 2:
Practice Address - City:GREENVALE
Practice Address - State:NY
Practice Address - Zip Code:11548-1220
Practice Address - Country:US
Practice Address - Phone:516-563-7857
Practice Address - Fax:516-563-7912
Is Sole Proprietor?:No
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS