Provider Demographics
NPI:1386749794
Name:MAROTTA, ERIC (DC)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:MAROTTA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 RODI RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15235
Mailing Address - Country:US
Mailing Address - Phone:412-241-4530
Mailing Address - Fax:412-241-4535
Practice Address - Street 1:400 RODI RD
Practice Address - Street 2:SUITE 3
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15235
Practice Address - Country:US
Practice Address - Phone:412-241-4530
Practice Address - Fax:412-241-4535
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005991L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016411090002Medicaid
U57247Medicare UPIN
PA0016411090002Medicaid