Basic Information
| Provider Information | |||||||||
| NPI: | 1659755536 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ERBIS | ||||||||
| FirstName: | COLLEEN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 333 ROUTE 25A | ||||||||
| Address2: | |||||||||
| City: | ROCKY POINT | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117788556 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6317443671 | ||||||||
| FaxNumber: | 6317446205 | ||||||||
| Practice Location | |||||||||
| Address1: | 333 ROUTE 25A | ||||||||
| Address2: | |||||||||
| City: | ROCKY POINT | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117788556 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6317443671 | ||||||||
| FaxNumber: | 6317446205 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2015 | ||||||||
| LastUpdateDate: | 07/10/2015 | ||||||||
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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 | 478502 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.