Provider Demographics
NPI:1861530214
Name:SECOR, ERIC RICHARD JR (ND,MS,LAC)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:RICHARD
Last Name:SECOR
Suffix:JR
Gender:M
Credentials:ND,MS,LAC
Other - Prefix:DR
Other - First Name:RICHARD
Other - Middle Name:
Other - Last Name:SECOR
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:ND,MS,LAC
Mailing Address - Street 1:25 COURT ST
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06051-2211
Mailing Address - Country:US
Mailing Address - Phone:860-229-1490
Mailing Address - Fax:860-223-0468
Practice Address - Street 1:25 COURT ST
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06051-2211
Practice Address - Country:US
Practice Address - Phone:860-229-1490
Practice Address - Fax:860-223-0468
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000088171100000X
CT000198175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist