Healthcare Provider Details

I. General information

NPI: 1922054931
Provider Name (Legal Business Name): ERIKA HUMPHREYS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 05/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1479 ROUTE 539 SUITE 1A
LITTLE EGG HARBOR TWP NJ
08087-9749
US

IV. Provider business mailing address

1479 ROUTE 539 SUITE 1A
LITTLE EGG HARBOR TWP NJ
08087-9749
US

V. Phone/Fax

Practice location:
  • Phone: 609-296-1900
  • Fax: 609-296-1906
Mailing address:
  • Phone: 609-296-1900
  • Fax: 609-296-1906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MA06802200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: