Healthcare Provider Details

I. General information

NPI: 1255959136
Provider Name (Legal Business Name): ERICA ROSE AITKEN RDN, CDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ERICA ROSE SMOLINSKI RDN, CDN

II. Dates (important events)

Enumeration Date: 07/08/2020
Last Update Date: 01/05/2022
Certification Date: 01/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 STERLING DR STE 201
ORCHARD PARK NY
14127-1577
US

IV. Provider business mailing address

7023 MEADOWBROOK CT
NORTH TONAWANDA NY
14120-9637
US

V. Phone/Fax

Practice location:
  • Phone: 716-704-0684
  • Fax: 716-625-1236
Mailing address:
  • Phone: 716-704-0684
  • Fax: 716-625-1236

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86150168
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number86150168
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: