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Individual

ERICA RAGAN MATLUCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ND, FNP

Contact information

Practice address
30 BROAD ST FL 45, NEW YORK, NY 10004-2942
(212) 530-0630
(212) 867-4353
Mailing address
30 BROAD ST FL 45, NEW YORK, NY 10004-2942
(212) 530-0630
(212) 867-4353

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
805445
CA
175F00000X
Naturopath
ND-480
CA
363L00000X
Nurse Practitioner
21394
CA
363L00000X
Nurse Practitioner
Primary
337922
NY

Other

Enumeration date
12/14/2011
Last updated
01/26/2018
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