Andrea M Ericksen

NPI #1841572336 in South Boston, Massachusetts

Provider Information

NPI Number: 1841572336
Entity Type: Individual
Name: Andrea M Ericksen
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Sep 12, 2011
Last Updated: Sep 12, 2011

Practice Location

Address: 58 OLD COLONY AVE
City: South Boston
State: Massachusetts
ZIP Code: 02127-2406
Phone: (617) 268-1700

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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