Provider Demographics
NPI:1154194462
Name:AMANTIA, ERIN ELISABETH
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:ELISABETH
Last Name:AMANTIA
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 1:319 WASHINGTON CROSSING PE RD
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08560-1515
Mailing Address - Country:US
Mailing Address - Phone:609-647-2706
Mailing Address - Fax:
Practice Address - Street 1:319 WASHINGTON CROSSING PE RD
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08560-1515
Practice Address - Country:US
Practice Address - Phone:609-647-2706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY837075163W00000X
NJ26NR20063400163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse