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NPI Code Detail

MEDICARE: DR. ERICA GIOVANNA LO RE D.O.

MEDICARE:  DR. ERICA GIOVANNA LO RE  D.O.
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
12084P0804XChild & Adolescent Psychiatry Physician285747NY
22084P0800XPsychiatry Physician285747NY

General Provider Information

NPI Number : 1356609911
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ERICA GIOVANNA LO RE D.O.
Provider Business Mailing Address
First Line : 15 BURKE LN
Second Line :
City : SYOSSET
State : NY
Zip : 11791-3932
Country : US
Telephone Number : 516-719-5250
Fax Number : 516-719-5198
Provider Business Practice Location Address
First Line : 15 BURKE LN
Second Line :
City : SYOSSET
State : NY
Zip : 11791-3932
Country : US
Telephone Number : 516-719-5250
Fax Number : 516-719-5198
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2012
Last Update Date : 04/17/2018

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