Healthcare Provider Details

I. General information

NPI: 1164011243
Provider Name (Legal Business Name): ERIKA M HYMAN MSN APRN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2021
Last Update Date: 08/05/2021
Certification Date: 08/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

580 COTTAGE GROVE RD STE 107
BLOOMFIELD CT
06002-3088
US

IV. Provider business mailing address

875 ENFIELD ST
ENFIELD CT
06082-3617
US

V. Phone/Fax

Practice location:
  • Phone: 860-243-8709
  • Fax:
Mailing address:
  • Phone: 860-741-3014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12.009448
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: