Healthcare Provider Details

I. General information

NPI: 1407275977
Provider Name (Legal Business Name): ERICA ELIZABETH TRAMONTANA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ERICA ELIZABETH RUVOLO

II. Dates (important events)

Enumeration Date: 04/14/2014
Last Update Date: 03/19/2021
Certification Date: 03/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 S MAIN ST
MIDDLETOWN CT
06457-3724
US

IV. Provider business mailing address

24 S 18TH ST
ALLENTOWN PA
18104-5622
US

V. Phone/Fax

Practice location:
  • Phone: 860-347-0720
  • Fax:
Mailing address:
  • Phone: 610-628-8372
  • Fax: 610-628-8648

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberOS019166
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number63501
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: