Provider Demographics
NPI:1245823640
Name:ERIKA MARIE HEGLAND DO PC
Entity type:Organization
Organization Name:ERIKA MARIE HEGLAND DO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:M
Authorized Official - Last Name:HEGLAND
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:315-218-0430
Mailing Address - Street 1:PO BOX 2003
Mailing Address - Street 2:
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057-4503
Mailing Address - Country:US
Mailing Address - Phone:315-362-5129
Mailing Address - Fax:
Practice Address - Street 1:5000 BRITTONFIELD PKWY STE A124
Practice Address - Street 2:
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057-9215
Practice Address - Country:US
Practice Address - Phone:315-218-0430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-17
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty