Provider Demographics
NPI:1639365091
Name:KAISER, ERIN MICHELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:MICHELLE
Last Name:KAISER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HOLLOW LN STE 301
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1215
Mailing Address - Country:US
Mailing Address - Phone:516-207-7851
Mailing Address - Fax:516-207-7851
Practice Address - Street 1:6630 MARIE CURIE DR
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-6402
Practice Address - Country:US
Practice Address - Phone:571-370-5437
Practice Address - Fax:571-370-3705
Is Sole Proprietor?:No
Enumeration Date:2007-09-19
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT 187919208000000X
MDD73077208000000X
VA0101272659208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD73077OtherMEDICAL LICENSE NUMB
PAMT187919OtherMEDICAL LISCENSE NUMBER