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General NPI Number Information
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NPI Number | 1639794753
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Entity Type | Individual
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Provider Name | ERIN LAW SW
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Gender | Female
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Dates
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Enumeration Date | 06/15/2020
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Last Update Date | 06/15/2020
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Provider Practice Location Address
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Address Line | 12 E 86TH ST OFC 4C
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City | NEW YORK
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State | NY
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Zip | 10028-0517
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Country | US
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Telephone | 212-861-6660
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Fax | 212-744-4696
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Provider Business Mailing Address
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Address Line | 1500 ROUTE 112 BLDG 4
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City | PORT JEFFERSON STATION
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State | NY
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Zip | 11776-8055
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Country | US
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Telephone | 631-751-3000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 108973
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License Number State | NY
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