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NPI Code Detail

MEDICARE: DR. DARIA MOLLIE ERIKSSON MD

MEDICARE: DR. DARIA MOLLIE ERIKSSON MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician239251NY

General Provider Information

NPI Number : 1083897722
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DARIA MOLLIE ERIKSSON MD
Provider Business Mailing Address
First Line : 575 W 181ST ST
Second Line : WASHINGTON HEIGHTS FAMILY HEALTH CENTER
City : NEW YORK
State : NY
Zip : 10033-5002
Country : US
Telephone Number : 212-342-3062
Fax Number :
Provider Business Practice Location Address
First Line : 575 W 181ST ST
Second Line : WASHINGTON HEIGHTS FAMILY HEALTH CENTER
City : NEW YORK
State : NY
Zip : 10033-5002
Country : US
Telephone Number : 212-342-3062
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/17/2007
Last Update Date : 12/17/2007

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