Provider Demographics
NPI:1104495829
Name:FERNITZ, ERIK KIRK (CTRS)
Entity type:Individual
Prefix:
First Name:ERIK
Middle Name:KIRK
Last Name:FERNITZ
Suffix:
Gender:M
Credentials:CTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2071 OLD PHILADELPHIA PIKE APT 25
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-5758
Mailing Address - Country:US
Mailing Address - Phone:717-669-5150
Mailing Address - Fax:
Practice Address - Street 1:1400 BLACKHORSE HILL RD BLDG 138
Practice Address - Street 2:
Practice Address - City:COATESVILLE
Practice Address - State:PA
Practice Address - Zip Code:19320-2040
Practice Address - Country:US
Practice Address - Phone:610-384-7711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-18
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist