Provider Demographics
NPI:1932934981
Name:KELLERMAN, ERIN KATHLEEN
Entity type:Individual
Prefix:MS
First Name:ERIN
Middle Name:KATHLEEN
Last Name:KELLERMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ERIN
Other - Middle Name:KATHLEEN
Other - Last Name:MANNING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:28 LAIGHT ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-2143
Mailing Address - Country:US
Mailing Address - Phone:917-861-9493
Mailing Address - Fax:
Practice Address - Street 1:329 E 62ND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-7769
Practice Address - Country:US
Practice Address - Phone:212-838-4333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program