ERICA OTTERBECK (NPI# 1649822073) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649822073 |
| Entity Type | Individual |
| Full Name | ERICA OTTERBECK |
| Practice Address |
329 Glenmont Rd Glenmont NY 12077-3469 |
| Mailing Address |
Po Box 233 East Greenbush NY 12061-0233 |
| Practice Telephone | 5182649000 |
| Mailing Telephone | 5185055081 |
| Enumeration Date | 2019-07-16 |
| Last Update Date | 2020-02-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 024755 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4 Jennell Dr, East Greenbush, NY 120611705 | 5185055081 |
| Street Address |
329 GLENMONT RD |
| City | GLENMONT |
| State | NY |
| Zip Code | 12077-3469 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831378165 | Teresa A Kirchner | Pharmacist | 329 Glenmont Rd, Glenmont, NY 12077-3468 | 2007-11-02 |
| 1154808483 | Lea Abel | Physician Assistant | 329 Glenmont Rd, Glenmont, NY 12077 | 2018-07-19 |
| 1952897613 | Danielle M Eckler | Physician Assistant | 329 Glenmont Rd, Glenmont, NY 12077-3469 | 2018-07-06 |
| 1669978847 | Albany Medical College | Emergency Medicine | 329 Glenmont Rd, Glenmont, NY 12077-3469 | 2018-04-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497869846 | Michael V. Conte Dds, PC | Clinic/Center | 336 Glenmont Rd., Glenmont, NY 12077 | 2006-08-19 |
| 1275646655 | Golub Corporation | Pharmacy | Town Squire Plaza, 329 Glenmont Rd, Glenmont, NY 12077 | 2006-08-17 |
| 1477525137 | Jeffrey P Riker | Chiropractor | 398 Feura Bush Rd, Glenmont, NY 12077 | 2006-02-06 |
| 1922386937 | Erica Cipriano Stevenson | Pharmacist | 311 Route 9w, Glenmont, NY 12077 | 2011-07-25 |
| 1831495076 | Heather Machabee | Registered Nurse | 328 Route 9w, Glenmont, NY 12077-2908 | 2011-02-07 |
| 1154348381 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 311 Route 9w, Glenmont, NY 12077-2909 | 2006-07-16 |
| 1760664122 | Treva Renee Braisted | Pharmacist | 311 Route 9w, Glenmont, NY 12077-2909 | 2007-11-28 |
| 1104008648 | Brian Decker | Pharmacist | 311 Route 9w, Glenmont, NY 12077-2909 | 2007-11-27 |
| 1043323348 | Wal-mart Stores East, Lp | Technician/Technologist | 311 Route 9w, Glenmont, NY 12077-2909 | 2006-08-17 |
| 1760723969 | Healthstat On-site Clinic/farm Family | Preventive Medicine | 344 Route 9w, Glenmont, NY 12077-2910 | 2013-03-13 |
| Find all providers in zip 12077 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154808483 | Lea Abel | Physician Assistant | 329 Glenmont Rd, Glenmont, NY 12077 | 2018-07-19 |
| 1952897613 | Danielle M Eckler | Physician Assistant | 329 Glenmont Rd, Glenmont, NY 12077-3469 | 2018-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144821026 | Victoria Yunaev | Physician Assistant | 7203 166th St, Fresh Meadows, NY 11365-3237 | 2020-11-05 |
| 1811598857 | Brittany Christine Androsko | Physician Assistant | 1769 Union St Fl 2, Niskayuna, NY 12309-6311 | 2020-11-05 |
| 1164023172 | Betina Charlotte Apostol Nuguid | Physician Assistant | 1730 Central Park Ave Ste 3p, Yonkers, NY 10710-4905 | 2020-11-05 |
| 1023619129 | Anna Leigh Vonck | Physician Assistant | 2 Executive Park Dr Ste 2, Albany, NY 12203-3700 | 2020-11-04 |
| 1952902256 | Billy Phuoctan Truong | Physician Assistant | 8832 18th Ave, Brooklyn, NY 11214-6002 | 2020-11-03 |
| 1205437621 | Jason Patrick Feak | Physician Assistant | 6338 Falls Blvd, Chittenango, NY 13037-8799 | 2020-11-03 |
| 1437750742 | Drew James Mitchell | Physician Assistant | 58 Old Bedford Rd, Goldens Bridge, NY 10526-1000 | 2020-11-03 |
| 1306446125 | Julie Mcphillips | Physician Assistant | 961 W Kaisertown Rd, Montgomery, NY 12549-2317 | 2020-10-30 |
| 1487254330 | Thomas J Nagel | Physician Assistant | 57 Montgomery Road, Fort Montgomery, NY 10922 | 2020-10-29 |
| 1700486560 | Jayanti Rao | Physician Assistant | 1059 Union St Apt 3g, Brooklyn, NY 11225-1268 | 2020-10-29 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.