Healthcare Provider Details

I. General information

NPI: 1306198668
Provider Name (Legal Business Name): ERICA MARRERO L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2012
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 OLD SOUTH RD # B
NANTUCKET MA
02554-2895
US

IV. Provider business mailing address

61 OLD SOUTH RD STE 201
NANTUCKET MA
02554-2960
US

V. Phone/Fax

Practice location:
  • Phone: 508-901-9574
  • Fax:
Mailing address:
  • Phone: 646-265-5274
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number261372
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: