Healthcare Provider Details

I. General information

NPI: 1164829495
Provider Name (Legal Business Name): CHRISTINA ERCOLE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2014
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 HUDSON ST FL 9
NEW YORK NY
10013-1810
US

IV. Provider business mailing address

1940 PALMER AVE
LARCHMONT NY
10538-2410
US

V. Phone/Fax

Practice location:
  • Phone: 646-941-7645
  • Fax: 929-596-7897
Mailing address:
  • Phone:
  • Fax: 914-895-7781

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF401736-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: