Provider Demographics
NPI:1104254747
Name:SEPPALA, ERICA DAWN (RN, BSN, MPH, MA)
Entity type:Individual
Prefix:MS
First Name:ERICA
Middle Name:DAWN
Last Name:SEPPALA
Suffix:
Gender:F
Credentials:RN, BSN, MPH, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2533 23RD ST
Mailing Address - Street 2:APT 1B
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102-2963
Mailing Address - Country:US
Mailing Address - Phone:718-517-0006
Mailing Address - Fax:
Practice Address - Street 1:2141 45TH RD
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-4706
Practice Address - Country:US
Practice Address - Phone:212-965-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-16
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY703261163WX0003X, 163WW0101X, 163WL0100X, 163WP1700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163WP1700XNursing Service ProvidersRegistered NursePerinatal