Organization
WISTERIA IMAGING INSTITUTE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIC ALEXANDER ADDO MD (OWNER)
(860) 262-4489
Entity
Organization
Contact information
Practice address
2835 WEST CHELTENHAM AVE, SUITE 312, PHILADELPHIA, PA 19150
(860) 262-4489
Mailing address
601 APALACHEE DR NE, ST PETERSBURG, FL 33702-2766
(860) 262-4489
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
10/17/2023
Last updated
10/17/2023
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