Provider Demographics
NPI:1124479514
Name:NEMZER, ERICA (MS)
Entity type:Individual
Prefix:MS
First Name:ERICA
Middle Name:
Last Name:NEMZER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 WICHARD BLVD
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-1707
Mailing Address - Country:US
Mailing Address - Phone:631-479-2900
Mailing Address - Fax:631-479-2900
Practice Address - Street 1:16 WICHARD BLVD
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-1707
Practice Address - Country:US
Practice Address - Phone:631-479-2900
Practice Address - Fax:631-479-2900
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-27
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1205161103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst