Eric Wydra D.O.

NPI 1245559194 - Student in an Organized Health Care Education/Training Program - 390200000X

NPI Details
NPI 1245559194
Gender Male
Enumeration Date 05/18/2010
Last Updated 05/18/2016
Entity Type Individual
Active Over 6 years ago
Practice Location
1505 W. SHERMAN AVENUE
DEPT OF RADIOLOGY
VINELAND NJ, 08360-6912, US
Phone (856) 641-7937
Fax
Business Location
1505 W. SHERMAN AVENUE
DEPT OF RADIOLOGY
VINELAND NJ, 08360-6912, US
Phone (732) 557-1781
Fax
Toxanomy
Taxonomy Code 390200000X
License State Pennsylvania
License Number OT013499
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According to our database, Eric Wydra D.O. NPI is 1245559194, taxonomy code is 390200000X and license number is OT013499, license state is located at Pennsylvania. Eric Wydra D.O. physically located at 1505 W. Sherman Avenue, Vineland NJ, 08360-6912. NPI Number Eric Wydra D.O. has the Individual type.

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1245559194 NPI number is provided on an as is basis without warranty of any kind. 1245559194 is maintained by the National Plan & Provider Enumeration System. The contents of Eric Wydra D.O. are for informational purposes only.