Provider Demographics
NPI:1336416205
Name:BASES, ERICA FRAN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ERICA
Middle Name:FRAN
Last Name:BASES
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:ERICA
Other - Middle Name:FELDMAN
Other - Last Name:BASES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:31 CHATHAM RD
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10804-2535
Mailing Address - Country:US
Mailing Address - Phone:914-261-0231
Mailing Address - Fax:914-261-0231
Practice Address - Street 1:83 OLD MAMARONECK RD
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-1903
Practice Address - Country:US
Practice Address - Phone:914-261-0231
Practice Address - Fax:914-261-0231
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-21
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018651-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist