Provider Demographics
NPI:1831702422
Name:BELLO-RODRIGUEZ, ERICA (APN)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:BELLO-RODRIGUEZ
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 N BROADWAY STE 102
Mailing Address - Street 2:
Mailing Address - City:SLEEPY HOLLOW
Mailing Address - State:NY
Mailing Address - Zip Code:10591-1019
Mailing Address - Country:US
Mailing Address - Phone:914-366-1625
Mailing Address - Fax:914-366-1603
Practice Address - Street 1:777 N BROADWAY STE 102
Practice Address - Street 2:
Practice Address - City:SLEEPY HOLLOW
Practice Address - State:NY
Practice Address - Zip Code:10591-1019
Practice Address - Country:US
Practice Address - Phone:914-366-1625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-25
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY309916363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health