Healthcare Provider Details

I. General information

NPI: 1275927303
Provider Name (Legal Business Name): ERICA HAILEY PARROTTA D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERICA HAILEY UTIGARD

II. Dates (important events)

Enumeration Date: 03/26/2015
Last Update Date: 06/04/2021
Certification Date: 06/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 SHAKER RD STE G01
ALBANY NY
12204-1030
US

IV. Provider business mailing address

PO BOX 14890
ALBANY NY
12212-4890
US

V. Phone/Fax

Practice location:
  • Phone: 518-429-2561
  • Fax:
Mailing address:
  • Phone: 518-525-5634
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number297695
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: