Healthcare Provider Details

I. General information

NPI: 1457779761
Provider Name (Legal Business Name): ERICA BETTINA CIMINELLI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2014
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4374 NEW TOWN AVE STE 202
WILLIAMSBURG VA
23188-2865
US

IV. Provider business mailing address

4374 NEW TOWN AVE STE 202
WILLIAMSBURG VA
23188-2865
US

V. Phone/Fax

Practice location:
  • Phone: 757-984-6040
  • Fax: 757-510-9063
Mailing address:
  • Phone: 757-984-6040
  • Fax: 757-510-9063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number300010
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101276342
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD83453
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: