Provider Demographics
NPI:1669154126
Name:VERDONIK, ERIN PATRICIA
Entity type:Individual
Prefix:MS
First Name:ERIN
Middle Name:PATRICIA
Last Name:VERDONIK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 LONG BEACH RD STE 20
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-3205
Mailing Address - Country:US
Mailing Address - Phone:516-669-0669
Mailing Address - Fax:
Practice Address - Street 1:3000 LONG BEACH RD STE 20
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-3205
Practice Address - Country:US
Practice Address - Phone:516-669-0669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-03
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031218-01225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist