Provider Demographics
NPI:1619428349
Name:STRAIGHT, ERIKA
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:STRAIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:543 SARATOGA RD
Mailing Address - Street 2:
Mailing Address - City:GLENVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12302-5711
Mailing Address - Country:US
Mailing Address - Phone:518-399-4624
Mailing Address - Fax:518-399-8663
Practice Address - Street 1:543 SARATOGA RD
Practice Address - Street 2:
Practice Address - City:GLENVILLE
Practice Address - State:NY
Practice Address - Zip Code:12302-5711
Practice Address - Country:US
Practice Address - Phone:518-399-4624
Practice Address - Fax:518-399-8663
Is Sole Proprietor?:No
Enumeration Date:2016-10-18
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist