Provider Information for 1306159819
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Dr. ERICA LOUISE WADDINGTON D.O.
Other Names:Other Name:Miss ERICA LOUISE JACOBSONSex: Female
NPI: 1306159819
Last Updated: 2014-10-21
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1306159819 | ||||||||||||
| Enumeration Date | 2010-07-26 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 130 HARTFORD RD MANCHESTER, CT 06040-5921 United States Phone: 860-533-5673 | Fax: | ||||||||||||
| Primary Practice Address | 130 HARTFORD RD MANCHESTER, CT 06040-5921 United States Phone: 860-533-4673 | Fax: | ||||||||||||
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