Provider Demographics
NPI:1104981927
Name:PEYTON-ALT, ERIN (RPA-C)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:
Last Name:PEYTON-ALT
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 SHORE RD
Mailing Address - Street 2:APARTMENT 3K
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-4650
Mailing Address - Country:US
Mailing Address - Phone:516-705-8939
Mailing Address - Fax:
Practice Address - Street 1:54 MAIN STREET
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550
Practice Address - Country:US
Practice Address - Phone:516-538-4531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009706363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical