Provider Demographics
NPI:1841573516
Name:SACCENTE, ERICA (NP-P)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:SACCENTE
Suffix:
Gender:F
Credentials:NP-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 AMSTERDAM AVE
Mailing Address - Street 2:SCRYMSER 3RD FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-1716
Mailing Address - Country:US
Mailing Address - Phone:212-523-6500
Mailing Address - Fax:212-523-5677
Practice Address - Street 1:1111 AMSTERDAM AVE
Practice Address - Street 2:SCRYMSER 3RD FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-1716
Practice Address - Country:US
Practice Address - Phone:212-523-6500
Practice Address - Fax:212-523-5677
Is Sole Proprietor?:No
Enumeration Date:2011-09-20
Last Update Date:2015-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF401429-1363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03430462Medicaid