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General NPI Number Information
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NPI Number | 1861622086
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Entity Type | Individual
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Provider Name | ERICA LYNN OLTRA M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/22/2009
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Last Update Date | 02/17/2023
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Provider Practice Location Address
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Address Line | 40 W 72ND ST
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City | NEW YORK
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State | NY
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Zip | 10023-4119
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Country | US
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Telephone | 212-981-9800
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Fax | 212-981-9818
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Provider Business Mailing Address
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Address Line | 5767 W CENTURY BLVD SUITE 400
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City | LOS ANGELES
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State | CA
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Zip | 90045-5631
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Country | US
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Telephone | 310-825-5000
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 274156
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License Number State | NY
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