Provider Demographics
NPI:1316932932
Name:WALBORN, ERIN M (AUD)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:M
Last Name:WALBORN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2 EMPIRE DR
Mailing Address - Street 2:SUITE 204
Mailing Address - City:RENSSELAER
Mailing Address - State:NY
Mailing Address - Zip Code:12144-5730
Mailing Address - Country:US
Mailing Address - Phone:518-283-6111
Mailing Address - Fax:518-283-6161
Practice Address - Street 1:2 EMPIRE DR
Practice Address - Street 2:SUITE 204
Practice Address - City:RENSSELAER
Practice Address - State:NY
Practice Address - Zip Code:12144-5730
Practice Address - Country:US
Practice Address - Phone:518-283-6111
Practice Address - Fax:518-283-6161
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001566-1231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY20-1672788OtherNYS EMPIRE PLAN/UH
NY20-1672788OtherCHAMPUS/TRICARE
NY000490164002OtherBS OF NENY
NY411525OtherMVP
NYM7441OtherEMPIRE BC/BS
NY10023791OtherCDPHP
NY37602OtherGHI/HMO & PPO
NY20-1672788OtherCHAMPUS/TRICARE