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Individual

ERIKA WICKSTROM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
22 W 15TH STREET, GROUND FL, NEW YORK, NY 10011
(646) 975-3700
Mailing address
888 OLD COUNTRY RD, PLAINVIEW, NY 11803-4914

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036178121
IL
207Q00000X
Family Medicine Physician
Primary
315218
NY

Other

Enumeration date
03/26/2020
Last updated
03/02/2026
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