Healthcare Provider Details

I. General information

NPI: 1952844847
Provider Name (Legal Business Name): ERICA TSAKIRIS APN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/23/2016
Last Update Date: 08/09/2023
Certification Date: 08/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 S BROADWAY
CAMDEN NJ
08103
US

IV. Provider business mailing address

317 S BROADWAY
CAMDEN NJ
08103-1253
US

V. Phone/Fax

Practice location:
  • Phone: 856-365-3519
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number26NJ00680100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: