ERIC WYDRA (NPI# 1245559194) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245559194 |
| Entity Type | Individual |
| Full Name | ERIC WYDRA |
| Credential | D.O. |
| Practice Address |
1505 W. Sherman Avenue Dept of Radiology Vineland NJ 08360-6912 |
| Practice Telephone | 8566417937 |
| Mailing Telephone | 7325571781 |
| Enumeration Date | 2010-05-18 |
| Last Update Date | 2016-05-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
25MB09715500 | NJ | Allopathic & Osteopathic Physicians |
| Street Address |
1505 W. SHERMAN AVENUE DEPT OF RADIOLOGY |
| City | VINELAND |
| State | NJ |
| Zip Code | 08360-6912 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275769978 | Omar Al Ustwani | Internal Medicine | 1505 W. Sherman Avenue, Suite 101, Vineland, NJ 08360 | 2009-06-09 |
| 1801388616 | Kyle John Mccormick | Student in an Organized Health Care Education/Training Program | 1505 W. Sherman Avenue, Vineland, NJ 08360 | 2018-06-06 |
| 1295161628 | Jacqueline Rounds | Family Medicine | 1505 W. Sherman Avenue, Vineland, NJ 08360 | 2013-09-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215534748 | Lindsay Gibbons | Social Worker | 60 W Ave, Vineland, NJ 08360 | 2020-10-07 |
| 1033769849 | Buena Vista Township Emergency Medical Services Inc. | Ambulance | 4931 E. Landis Ave., Vineland, NJ 08360 | 2019-09-13 |
| 1669037636 | Elwyn New Jersey | Day Training, Developmentally Disabled Services | Elwyn New Jersey Supported Employment Small Group, 228 W. Landis Avenue, Suite 302, Vineland, NJ 08360 | 2019-05-06 |
| 1972001519 | Kyle James Knowles | Physician Assistant | 1138 East Chestnut Avenue, Building 8 Suite B, Vineland, NJ 08360 | 2018-01-29 |
| 1205346574 | Maryville, Inc | Clinic/Center | 1173 E Landis Ave, Vineland, NJ 08360 | 2017-10-02 |
| 1184147043 | Sarah Lee | Pharmacist | 75 W Landis Ave, Vineland, NJ 08360 | 2017-07-24 |
| 1780111419 | Elwyn New Jersey | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 30 D'shibe Terrace, Vineland, NJ 08360 | 2017-05-12 |
| 1528414810 | Khushbu V Janani | Internal Medicine | 1505 W Sherman Avenue, Inspira Health Network, Vineland, NJ 08360 | 2016-05-05 |
| 1669841409 | University Womens Imaging LLC | Clinic/Center | 1051 West Sherman Avenue, Suite 4a, Vineland, NJ 08360 | 2015-09-23 |
| 1710369350 | Elwyn New Jersey | Day Training, Developmentally Disabled Services | 46 N West Ave, Building A, Vineland, NJ 08360 | 2015-06-19 |
| Find all providers in zip 08360 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497700702 | Garden State Mri Corp | Radiology | 1470 S Main Rd, Building 2, Vineland, NJ 08360-6588 | 2006-05-24 |
| 1902051402 | Vineland Mri PC | Radiology | 2848 S Delsea Dr, Vineland, NJ 08360-7042 | 2008-11-25 |
| 1902014749 | Nitesh N Bhagat | Radiology | 1505 W Sherman Ave, Vineland, NJ 08360-6912 | 2007-05-17 |
| 1407868201 | University Imaging Center LLC | Radiology | 1051 W Sherman Ave, Ste 2b, Vineland, NJ 08360-6931 | 2006-08-12 |
| 1598795932 | Bridget D Bernardi | Radiology | 1505 W Sherman Ave, Vineland, NJ 08360-6912 | 2006-07-03 |
| 1285675389 | Jacqueline S Gomberg | Radiology | 1505 W Sherman Ave, Vineland, NJ 08360-6912 | 2006-06-09 |
| 1730129826 | Satish P Shah | Radiology | 1450 E Chestnut Ave, Building 4, Suite A, Vineland, NJ 08361-8467 | 2006-06-07 |
| 1285674358 | Steven H Rothfarb | Radiology | 1450 E Chestnut Ave, Building 4, Suite A, Vineland, NJ 08361-8467 | 2006-06-07 |
| 1073553152 | Shailendra A Desai | Radiology | 1450 E Chestnut Ave, Building 4, Suite A, Vineland, NJ 08361-8467 | 2006-06-07 |
| 1265489207 | Ernesto B Go | Radiology | 1450 E Chestnut Ave, Building 4, Suite A, Vineland, NJ 08361-8467 | 2006-05-27 |
| Find all providers in VINELAND | ||||
Please comment or provide details below to improve the information on ERIC WYDRA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.