MEDICARE: ERICA TSAKIRIS APN

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	363LW0102X	Women's Health Nurse Practitioner	26NJ00680100	NJ

General Provider Information

NPI Number	:	1952844847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICA TSAKIRIS APN

Provider Business Mailing Address
First Line	:	317 S BROADWAY
Second Line	:
City	:	CAMDEN
State	:	NJ
Zip	:	08103-1253
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	317 S BROADWAY
Second Line	:
City	:	CAMDEN
State	:	NJ
Zip	:	08103
Country	:	US
Telephone Number	:	856-365-3519
Fax Number	:

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

Provider Enumeration Date	:	11/23/2016
Last Update Date	:	08/09/2023

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