Healthcare Provider Details

I. General information

NPI: 1558176362
Provider Name (Legal Business Name): ERICA CAMARDESE ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2025
Last Update Date: 02/10/2025
Certification Date: 02/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 CLEVER RD
MC KEES ROCKS PA
15136-4012
US

IV. Provider business mailing address

16 SCHULER LN
CORAOPOLIS PA
15108-3308
US

V. Phone/Fax

Practice location:
  • Phone: 412-716-9945
  • Fax:
Mailing address:
  • Phone: 412-716-9945
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberRT003576
License Number StatePA

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: