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Individual

MS. ERIKO KIDA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-7401
(718) 920-2058
Mailing address
645 W 239TH ST, 3G, BRONX, NY 10463-1234

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
007150-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00245643
NY
Enumeration date
03/07/2007
Last updated
05/27/2008
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