Provider Demographics
NPI:1144420316
Name:FORSELL, ERIKA (ERIKA FORSELL, LAC)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:FORSELL
Suffix:
Gender:F
Credentials:ERIKA FORSELL, LAC
Other - Prefix:
Other - First Name:ERIKA
Other - Middle Name:
Other - Last Name:WREN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:119 CALYER ST
Mailing Address - Street 2:#2
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11222-6329
Mailing Address - Country:US
Mailing Address - Phone:646-483-3858
Mailing Address - Fax:
Practice Address - Street 1:19 W 21ST ST
Practice Address - Street 2:#904
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-6805
Practice Address - Country:US
Practice Address - Phone:212-229-1220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003530171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist