Provider Demographics
NPI:1124351283
Name:HORNAK, ERICKA MARIE (PT)
Entity type:Individual
Prefix:
First Name:ERICKA
Middle Name:MARIE
Last Name:HORNAK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1086 STATE ROUTE 315
Mailing Address - Street 2:
Mailing Address - City:PLAINS
Mailing Address - State:PA
Mailing Address - Zip Code:18702
Mailing Address - Country:US
Mailing Address - Phone:570-823-7761
Mailing Address - Fax:570-822-8033
Practice Address - Street 1:1086 STATE ROUTE 315
Practice Address - Street 2:
Practice Address - City:PLAINS
Practice Address - State:PA
Practice Address - Zip Code:18702
Practice Address - Country:US
Practice Address - Phone:570-823-7761
Practice Address - Fax:570-822-8033
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-08
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT020084225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist