Provider Demographics
NPI:1710609862
Name:D'ERRICO, ERICA (FNP)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:D'ERRICO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:963 ROUTE 146 STE 1
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-3636
Mailing Address - Country:US
Mailing Address - Phone:518-579-0012
Mailing Address - Fax:
Practice Address - Street 1:963 ROUTE 146 STE 1
Practice Address - Street 2:
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-3636
Practice Address - Country:US
Practice Address - Phone:518-579-0012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-15
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF349945363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF349945OtherFNP LICENSE NUMBER