Healthcare Provider Details

I. General information

NPI: 1003039637
Provider Name (Legal Business Name): ERIKA A DAMON RD, LDN, CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERIKA A SCHLICHTING RD

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 03/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 MEMORIAL DR STE 113
LEOMINSTER MA
01453-2238
US

IV. Provider business mailing address

50 MEMORIAL DR STE 113
LEOMINSTER MA
01453-2238
US

V. Phone/Fax

Practice location:
  • Phone: 978-466-4580
  • Fax:
Mailing address:
  • Phone: 978-466-4580
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1222
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: