Healthcare Provider Details

I. General information

NPI: 1366267254
Provider Name (Legal Business Name): ERICKA E SAENZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2024
Last Update Date: 11/18/2024
Certification Date: 11/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 LOWER MAIN ST UNIT 1
CALLICOON NY
12723-5001
US

IV. Provider business mailing address

PO BOX 104
CALLICOON NY
12723-0104
US

V. Phone/Fax

Practice location:
  • Phone: 800-344-5439
  • Fax: 800-344-5439
Mailing address:
  • Phone: 800-344-5439
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: