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Contact Information

ERIC WYDRA, DO
1505 W. SHERMAN AVENUE
DEPT OF RADIOLOGY
VINELAND, NJ08360-6912
 Phone: 856-641-7937
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Diagnostic Radiology

2085R0202X 30 Physician/Diagnostic Radiology
 

Neuroradiology

2085N0700X
Indicates primary specialty

NPI Profile & details for ERIC WYDRA · (Male)

NPI # 1245559194
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 05/18/2010
Last updated 05/28/2024 - About 2 years ago
Sole proprietor 1 Yes
Identifiers
  • ND License # 21074
  • NJ License # 25MB09715500
Hospital affiliation(s)
  • SOUTH JERSEY HEALTHCARE REGIONAL MEDICAL CENTER - (Acute Care)
    1505 W SHERMAN AVE
    VINELAND, NJ 08360
  • SOUTH JERSEY HEALTHCARE-ELMER HOSPITAL - (Acute Care)
    501 WEST FRONT STREET
    ELMER, NJ 08318
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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