Healthcare Provider Details

I. General information

NPI: 1407197932
Provider Name (Legal Business Name): ERICA SGROE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2013
Last Update Date: 10/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

967 N BROADWAY
YONKERS NY
10701-1301
US

IV. Provider business mailing address

967 N BROADWAY
YONKERS NY
10701-1301
US

V. Phone/Fax

Practice location:
  • Phone: 914-798-8956
  • Fax:
Mailing address:
  • Phone: 914-798-8956
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number657409
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberF430801-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: