Provider Demographics
NPI:1659530863
Name:FERENCHICK, ERIN (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:
Last Name:FERENCHICK
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 1:610 W 158TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-7104
Mailing Address - Country:US
Mailing Address - Phone:212-544-1880
Mailing Address - Fax:
Practice Address - Street 1:610 W 158TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-7104
Practice Address - Country:US
Practice Address - Phone:212-544-1880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2014-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY256724207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine