Basic Information
Provider Information
NPI: 1033558390
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LUFT
FirstName: ERICKA
MiddleName: DANIELLE
NamePrefix: DR.
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1020 N UNION ST
Address2:  
City: MIDDLETOWN
State: PA
PostalCode: 170572158
CountryCode: US
TelephoneNumber: 7179301271
FaxNumber: 7179301212
Practice Location
Address1: 1020 N UNION ST
Address2:  
City: MIDDLETOWN
State: PA
PostalCode: 170572158
CountryCode: US
TelephoneNumber: 7179301271
FaxNumber: 7179301212
Other Information
ProviderEnumerationDate: 06/20/2013
LastUpdateDate: 06/20/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPT016013PAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


Home