Healthcare Provider Details

I. General information

NPI: 1356250427
Provider Name (Legal Business Name): ERIKA MIANO PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

481 PENBROOKE DR STE 6
PENFIELD NY
14526-2044
US

IV. Provider business mailing address

92 OAKBRIAR CT
PENFIELD NY
14526-2637
US

V. Phone/Fax

Practice location:
  • Phone: 585-606-3083
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number409154
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: