Provider Demographics
NPI:1821415506
Name:QUEZADA-YORK, ERICKA ELIZABETH (CNM, RN)
Entity Type:Individual
Prefix:
First Name:ERICKA
Middle Name:ELIZABETH
Last Name:QUEZADA-YORK
Suffix:
Gender:F
Credentials:CNM, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 5TH AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-4013
Mailing Address - Country:US
Mailing Address - Phone:917-742-0985
Mailing Address - Fax:
Practice Address - Street 1:14 DEKALB AVE FL 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5311
Practice Address - Country:US
Practice Address - Phone:718-875-4848
Practice Address - Fax:718-808-9548
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-19
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001596176B00000X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife