Provider Demographics
NPI:1023682911
Name:JANE EGAN-ERBE, LLC
Entity type:Organization
Organization Name:JANE EGAN-ERBE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANE
Authorized Official - Middle Name:M
Authorized Official - Last Name:EGAN-ERBE
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:917-365-9414
Mailing Address - Street 1:1200 HIGH RIDGE RD # B10
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-1223
Mailing Address - Country:US
Mailing Address - Phone:917-365-9414
Mailing Address - Fax:
Practice Address - Street 1:1200 HIGH RIDGE RD., 3RD. FL
Practice Address - Street 2:SMART PEDIATRICS
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-0690
Practice Address - Country:US
Practice Address - Phone:917-365-9414
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-17
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1902085293OtherTHERAPIST