Provider Demographics
NPI:1295966620
Name:LANDER, ERICA CHERYL (PSYD)
Entity type:Individual
Prefix:DR
First Name:ERICA
Middle Name:CHERYL
Last Name:LANDER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:178 E 80TH ST APT 11E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-0469
Mailing Address - Country:US
Mailing Address - Phone:201-572-9637
Mailing Address - Fax:
Practice Address - Street 1:3010 BRIGGS AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-1606
Practice Address - Country:US
Practice Address - Phone:718-563-5263
Practice Address - Fax:718-295-4587
Is Sole Proprietor?:No
Enumeration Date:2009-08-03
Last Update Date:2009-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018204103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist