Provider Demographics
NPI:1750678777
Name:SCHMETTAN, ERICA ARLENE
Entity type:Individual
Prefix:MS
First Name:ERICA
Middle Name:ARLENE
Last Name:SCHMETTAN
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 1:127 LONG ISLAND AVE
Mailing Address - Street 2:
Mailing Address - City:YAPHANK
Mailing Address - State:NY
Mailing Address - Zip Code:11980-9604
Mailing Address - Country:US
Mailing Address - Phone:631-834-9024
Mailing Address - Fax:
Practice Address - Street 1:2 WESTCLIFF DR
Practice Address - Street 2:MOUNT SINAI
Practice Address - City:MOUNT SINAI
Practice Address - State:NY
Practice Address - Zip Code:11766-2220
Practice Address - Country:US
Practice Address - Phone:631-834-9024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-29
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY640128163WH0200X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163W00000XNursing Service ProvidersRegistered Nurse