MEDICARE: PPN IPA INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	2251G0304X	Geriatric Physical Therapist
2	224Z00000X	Occupational Therapy Assistant
3	2251H1200X	Hand Physical Therapist
4	2251P0200X	Pediatric Physical Therapist
5	2251E1300X	Clinical Electrophysiology Physical Therapist
6	225700000X	Massage Therapist
7	2251S0007X	Sports Physical Therapist
8	2251X0800X	Orthopedic Physical Therapist
9	225X00000X	Occupational Therapist
10	225200000X	Physical Therapy Assistant
11	2255A2300X	Athletic Trainer
12	225XH1200X	Hand Occupational Therapist
13	225XP0200X	Pediatric Occupational Therapist
14	235Z00000X	Speech-Language Pathologist
15	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1023823374
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PPN IPA INC

Provider Business Mailing Address
First Line	:	84 CORTLAND ST
Second Line	:
City	:	HOMER
State	:	NY
Zip	:	13077-1517
Country	:	US
Telephone Number	:	607-749-2219
Fax Number	:	607-749-2286

Provider Business Practice Location Address
First Line	:	84 CORTLAND ST
Second Line	:
City	:	HOMER
State	:	NY
Zip	:	13077-1517
Country	:	US
Telephone Number	:	607-749-2219
Fax Number	:	607-749-2286

Authorized Official
Title or Position	:	CO-CHAIRPERSON
Name	:	DR. EHREN HEYER
Credential	:	DPT
Telephone Number	:	607-749-2219

Provider Enumeration Date	:	02/12/2025
Last Update Date	:	02/12/2025

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Directions to “PPN IPA INC ” Practice Location

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