Healthcare Provider Details

I. General information

NPI: 1780592253
Provider Name (Legal Business Name): ERIKA NERZAK OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 TITUS PL
WALTON NY
13856-1457
US

IV. Provider business mailing address

30 EVERGREEN ST
AFTON NY
13730-2125
US

V. Phone/Fax

Practice location:
  • Phone: 607-865-2155
  • Fax:
Mailing address:
  • Phone: 607-662-3595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number031370
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: