Provider Demographics
NPI:1881201846
Name:CONERY, ERICA ANNE (RN, BSN)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:ANNE
Last Name:CONERY
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1615 BERNE-ALTAMONT RD.
Mailing Address - Street 2:
Mailing Address - City:ALTAMONT
Mailing Address - State:NY
Mailing Address - Zip Code:12009-3216
Mailing Address - Country:US
Mailing Address - Phone:518-641-9486
Mailing Address - Fax:518-489-8300
Practice Address - Street 1:1615 BERNE-ALTAMONT RD.
Practice Address - Street 2:
Practice Address - City:ALTAMONT
Practice Address - State:NY
Practice Address - Zip Code:12009-3216
Practice Address - Country:US
Practice Address - Phone:518-641-9486
Practice Address - Fax:518-489-8300
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-24
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY673650163WH0200X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty