Provider Demographics
NPI:1841445483
Name:ERWAY, MARY JUANITA (NP)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:JUANITA
Last Name:ERWAY
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 1:7 GREEN HILL LN
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-2103
Mailing Address - Country:US
Mailing Address - Phone:585-472-6366
Mailing Address - Fax:
Practice Address - Street 1:7 GREEN HILL LN
Practice Address - Street 2:
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-2103
Practice Address - Country:US
Practice Address - Phone:585-472-6366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-24
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF332669363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily