Provider Demographics
NPI:1720301815
Name:PLATA, ERYN
Entity type:Individual
Prefix:
First Name:ERYN
Middle Name:
Last Name:PLATA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ERYN
Other - Middle Name:
Other - Last Name:BREIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 MCGREGOR ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03102-3730
Mailing Address - Country:US
Mailing Address - Phone:603-314-4771
Mailing Address - Fax:603-663-2006
Practice Address - Street 1:100 MCGREGOR ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-3730
Practice Address - Country:US
Practice Address - Phone:603-314-4771
Practice Address - Fax:603-663-2006
Is Sole Proprietor?:No
Enumeration Date:2010-03-03
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA20863363A00000X
NH1737363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant