Healthcare Provider Details

I. General information

NPI: 1609405380
Provider Name (Legal Business Name): ERICA ZUCCOLOTTO PT, DPT, LAT, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2020
Last Update Date: 10/23/2024
Certification Date: 10/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4247 W RIDGE RD
ERIE PA
16506-1746
US

IV. Provider business mailing address

11268 E LAW RD
NORTH EAST PA
16428-3805
US

V. Phone/Fax

Practice location:
  • Phone: 814-838-2468
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT032488
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberRT007809
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: