Provider Demographics
NPI:1720171366
Name:ERGIN, NURCAN (NP)
Entity Type:Individual
Prefix:MISS
First Name:NURCAN
Middle Name:
Last Name:ERGIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 WEST AVENUE, SUITE 109
Mailing Address - Street 2:
Mailing Address - City:BROCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14420
Mailing Address - Country:US
Mailing Address - Phone:585-637-2161
Mailing Address - Fax:585-637-5819
Practice Address - Street 1:80 WEST AVENUE, SUITE 109
Practice Address - Street 2:
Practice Address - City:BROCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14420
Practice Address - Country:US
Practice Address - Phone:585-637-2161
Practice Address - Fax:585-637-5819
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF303356363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRA6196Medicare ID - Type Unspecified