Provider Demographics
NPI:1538436134
Name:BARTOLONI, ERICA (MS, PA-C)
Entity type:Individual
Prefix:MISS
First Name:ERICA
Middle Name:
Last Name:BARTOLONI
Suffix:
Gender:F
Credentials:MS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P O BOX 714518
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45721-4518
Mailing Address - Country:US
Mailing Address - Phone:212-535-3505
Mailing Address - Fax:212-535-3568
Practice Address - Street 1:115 E 57TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-2049
Practice Address - Country:US
Practice Address - Phone:877-463-7264
Practice Address - Fax:212-535-3568
Is Sole Proprietor?:No
Enumeration Date:2011-11-27
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015074363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant