Basic Information
| Provider Information | |||||||||
| NPI: | 1366518870 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FERBER | ||||||||
| FirstName: | ERIN | ||||||||
| MiddleName: | |||||||||
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| Credential: | CRNA | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | GREEN | ||||||||
| OtherFirstName: | ERIN | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 100 ROUTE 59 | ||||||||
| Address2: | SUITE 105 | ||||||||
| City: | SUFFERN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 109014927 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8453575775 | ||||||||
| FaxNumber: | 8453575777 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 BAY AVENUE | ||||||||
| Address2: | MOUNTAINSIDE HOSPITAL | ||||||||
| City: | MONTCLAIR | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07042 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9734296000 | ||||||||
| FaxNumber: | 8453575777 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/27/2006 | ||||||||
| LastUpdateDate: | 05/16/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 26NR10013600 | NJ | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 367500000X | 26NJ00199600 | NJ | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.