Provider Demographics
NPI:1053910059
Name:GURDINEER, ERIN ELIZABETH (PSYD)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:ELIZABETH
Last Name:GURDINEER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 608
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12134-0608
Mailing Address - Country:US
Mailing Address - Phone:518-863-7000
Mailing Address - Fax:
Practice Address - Street 1:131 SOUTH THIRD ST
Practice Address - Street 2:
Practice Address - City:NORTHVILLE
Practice Address - State:NY
Practice Address - Zip Code:12134-0608
Practice Address - Country:US
Practice Address - Phone:518-863-7000
Practice Address - Fax:518-863-9197
Is Sole Proprietor?:No
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023695-01103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool