MEDICARE: ERIK ANDREW OATMAN PA

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
1	363A00000X	Physician Assistant	026511	NY
2	363A00000X	Physician Assistant

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	026511	OTHER	NY	NEW YORK STATE DOE

General Provider Information

NPI Number	:	1639755754
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIK ANDREW OATMAN PA

Provider Business Mailing Address
First Line	:	1901 1ST AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10029-7491
Country	:	US
Telephone Number	:	212-423-6262
Fax Number	:

Provider Business Practice Location Address
First Line	:	153 CLINTON ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201-4601
Country	:	US
Telephone Number	:	212-430-6677
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2021
Last Update Date	:	08/29/2022

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