Individual
MRS. ERIN KATHLEEN BAMBACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
30 LAFAYETTE SQ STE 109, VERNON, CT 06066-4554
(800) 391-0599
(980) 825-7196
Mailing address
36 MAMANASCO RD, RIDGEFIELD, CT 06877-2425
(203) 837-0677
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
135987
CT
163W00000X
Registered Nurse
722804
NY
363LF0000X
Family Nurse Practitioner
Primary
12298
CT
363LF0000X
Family Nurse Practitioner
352692
NY
Other
Enumeration date
11/28/2023
Last updated
08/21/2025
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