Healthcare Provider Details

I. General information

NPI: 1639810872
Provider Name (Legal Business Name): ERICA BOCCIA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2022
Last Update Date: 08/22/2025
Certification Date: 08/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9221 ROBERT HART DR
DANSVILLE NY
14437-8931
US

IV. Provider business mailing address

9221 ROBERT HART DR
DANSVILLE NY
14437-8931
US

V. Phone/Fax

Practice location:
  • Phone: 585-335-4316
  • Fax:
Mailing address:
  • Phone: 585-335-4316
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number403533
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF403533-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: