Provider Demographics
NPI:1023016011
Name:WASSERMAN, ERIC L (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:L
Last Name:WASSERMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1275 SUMMER ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-5359
Mailing Address - Country:US
Mailing Address - Phone:203-978-0800
Mailing Address - Fax:203-674-8519
Practice Address - Street 1:1275 SUMMER ST
Practice Address - Street 2:SUITE 200
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5359
Practice Address - Country:US
Practice Address - Phone:203-978-0800
Practice Address - Fax:203-674-8519
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2013-01-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT028681207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT180000379OtherPTAN
CTC23196Medicare UPIN