Healthcare Provider Details

I. General information

NPI: 1811500457
Provider Name (Legal Business Name): NIKOLAS SCOTT KAMINSKI NREMT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2020
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 E CHURCH ST STE B
LIGONIER PA
15658-1257
US

IV. Provider business mailing address

5184 WATTERS RD
LOWER BURRELL PA
15068-8701
US

V. Phone/Fax

Practice location:
  • Phone: 724-238-2099
  • Fax: 724-238-2119
Mailing address:
  • Phone: 724-681-9827
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberRT008575
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT033797
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: