Basic Information
| Provider Information | |||||||||
| NPI: | 1841877800 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZISKIN | ||||||||
| FirstName: | ERICA | ||||||||
| MiddleName: | KATHERINE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 KATHERINE DR | ||||||||
| Address2: | |||||||||
| City: | BURNT HILLS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 120279794 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5186055055 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2215 BURDETT AVE | ||||||||
| Address2: | |||||||||
| City: | TROY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 121802466 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5182713300 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/25/2021 | ||||||||
| LastUpdateDate: | 03/25/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 1171554 | NY | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.