Provider Demographics
NPI:1770533010
Name:NIEVES, ERIKA (MS,RN,ANP)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:NIEVES
Suffix:
Gender:F
Credentials:MS,RN,ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:693 KIMBALL AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10704-1533
Mailing Address - Country:US
Mailing Address - Phone:917-209-4324
Mailing Address - Fax:
Practice Address - Street 1:693 KIMBALL AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10704-1533
Practice Address - Country:US
Practice Address - Phone:917-209-4324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY489035163W00000X
NY3042351363L00000X
NYF304235-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY26-1444128OtherEIN
NY035XKZXTZ1Medicare PIN