Healthcare Provider Details

I. General information

NPI: 1821415506
Provider Name (Legal Business Name): ERICKA ELIZABETH QUEZADA-YORK CNM, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2014
Last Update Date: 05/10/2022
Certification Date: 05/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 DEKALB AVE FL 2
BROOKLYN NY
11201-5311
US

IV. Provider business mailing address

430 5TH AVE FL 2
BROOKLYN NY
11215-4013
US

V. Phone/Fax

Practice location:
  • Phone: 718-875-4848
  • Fax: 718-808-9548
Mailing address:
  • Phone: 917-742-0985
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number001596
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number001596
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: