Healthcare Provider Details

I. General information

NPI: 1891630612
Provider Name (Legal Business Name): ERIKA LYNN ANDREOLI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1389 W MAIN ST STE 225
WATERBURY CT
06708-3115
US

IV. Provider business mailing address

44 OSBORN RD APT D9
NAUGATUCK CT
06770-4760
US

V. Phone/Fax

Practice location:
  • Phone: 203-757-1474
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number48.006153
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: