Provider Demographics
NPI:1366703332
Name:EGRESITZ, ERIN JEAN
Entity type:Individual
Prefix:MS
First Name:ERIN
Middle Name:JEAN
Last Name:EGRESITZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 DAWN DR
Mailing Address - Street 2:
Mailing Address - City:WESTTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10998-2824
Mailing Address - Country:US
Mailing Address - Phone:845-742-0485
Mailing Address - Fax:
Practice Address - Street 1:163 DAWN DR
Practice Address - Street 2:
Practice Address - City:WESTTOWN
Practice Address - State:NY
Practice Address - Zip Code:10998-2824
Practice Address - Country:US
Practice Address - Phone:845-742-0485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator