Provider Demographics
NPI:1972747319
Name:NANCE, ERIN MCDERMOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:MCDERMOTT
Last Name:NANCE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ERIN
Other - Middle Name:MARY
Other - Last Name:MCDERMOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:250 E 65TH ST APT 13B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-6617
Mailing Address - Country:US
Mailing Address - Phone:516-987-0103
Mailing Address - Fax:
Practice Address - Street 1:800A 5TH AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-7215
Practice Address - Country:US
Practice Address - Phone:516-987-0103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-29
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY274422-1207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04151135Medicaid