MEDICARE: DR. ROY H ERIKSEN 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
1	207R00000X	Internal Medicine Physician	119911	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881716934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROY H ERIKSEN MD

Provider Business Mailing Address
First Line	:	311 N MIDLAND AVE
Second Line	:
City	:	NYACK
State	:	NY
Zip	:	10960-1627
Country	:	US
Telephone Number	:	845-358-5006
Fax Number	:	845-358-4340

Provider Business Practice Location Address
First Line	:	311 N MIDLAND AVE
Second Line	:
City	:	NYACK
State	:	NY
Zip	:	10960-1627
Country	:	US
Telephone Number	:	845-358-5006
Fax Number	:	845-358-4340

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

Provider Enumeration Date	:	04/06/2007
Last Update Date	:	03/29/2026

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