Healthcare Provider Details

I. General information

NPI: 1346219094
Provider Name (Legal Business Name): ERIKA JEAN NETZORG DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

689 UNIONVILLE RD
KENNETT SQUARE PA
19348-1787
US

IV. Provider business mailing address

103 HILLSIDE LN
KENNETT SQUARE PA
19348-2267
US

V. Phone/Fax

Practice location:
  • Phone: 610-444-9010
  • Fax: 610-444-9027
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT 017579
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberJ1-0001979
License Number StateDE
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateME

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: