Provider Demographics
NPI:1386404606
Name:GROODY, ERIC
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:GROODY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 VILLA CT APT 3
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:PA
Mailing Address - Zip Code:19526-8083
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:125 HOLLY RD
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:PA
Practice Address - Zip Code:19526-8729
Practice Address - Country:US
Practice Address - Phone:610-562-2284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist