Provider Demographics
NPI:1134251101
Name:HIBY, ERIKA HSIU (MD)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:HSIU
Last Name:HIBY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-8438
Mailing Address - Country:US
Mailing Address - Phone:631-206-2901
Mailing Address - Fax:631-206-0168
Practice Address - Street 1:340 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-8438
Practice Address - Country:US
Practice Address - Phone:631-206-2901
Practice Address - Fax:631-206-0168
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY241606207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0214765Medicaid
NY0D3181Medicare ID - Type Unspecified
NYH23132Medicare UPIN