Healthcare Provider Details

I. General information

NPI: 1679754238
Provider Name (Legal Business Name): ERIKA LOW P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/23/2007
Last Update Date: 08/26/2020
Certification Date: 08/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 1ST AVE HCC 14
NEW YORK NY
10016-6402
US

IV. Provider business mailing address

300 POST RD WEST 1ST FLOOR
WESTPORT CT
06880-4703
US

V. Phone/Fax

Practice location:
  • Phone: 212-263-5656
  • Fax:
Mailing address:
  • Phone: 203-332-3272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number4965
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number012301
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: