Provider Demographics
NPI:1710394028
Name:CARD, ERIN
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:
Last Name:CARD
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ERIN
Other - Middle Name:
Other - Last Name:PENDERGAST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:43 WESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-8327
Mailing Address - Country:US
Mailing Address - Phone:845-567-1279
Mailing Address - Fax:
Practice Address - Street 1:43 WESTWOOD DR
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-8327
Practice Address - Country:US
Practice Address - Phone:845-567-1279
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-18
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY414265101174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist