Basic Information
Provider Information
NPI: 1902279417
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARANASKAS
FirstName: ERIKA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 800 WESTCHESTER AVE STE N715
Address2:  
City: RYE BROOK
State: NY
PostalCode: 105731369
CountryCode: US
TelephoneNumber: 9146075730
FaxNumber: 9144571195
Practice Location
Address1: 210 WESTCHESTER AVE
Address2:  
City: WHITE PLAINS
State: NY
PostalCode: 106042901
CountryCode: US
TelephoneNumber: 9146076250
FaxNumber: 9146076252
Other Information
ProviderEnumerationDate: 11/05/2015
LastUpdateDate: 01/31/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/31/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0200X340029NYN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
363LP0200XF340029NYN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
363LF0000X340029NYY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


Home