Healthcare Provider Details

I. General information

NPI: 1639755754
Provider Name (Legal Business Name): ERIK ANDREW OATMAN PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2021
Last Update Date: 08/29/2022
Certification Date: 08/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

153 CLINTON ST
BROOKLYN NY
11201-4601
US

IV. Provider business mailing address

1901 1ST AVE
NEW YORK NY
10029-7491
US

V. Phone/Fax

Practice location:
  • Phone: 212-430-6677
  • Fax:
Mailing address:
  • Phone: 212-423-6262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number026511
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: