Provider Demographics
NPI:1588276638
Name:RADERMACHER, ERIK JOSEF (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:ERIK
Middle Name:JOSEF
Last Name:RADERMACHER
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 FAIRWAY ST
Mailing Address - Street 2:
Mailing Address - City:MATTAPAN
Mailing Address - State:MA
Mailing Address - Zip Code:02126-2153
Mailing Address - Country:US
Mailing Address - Phone:617-298-2225
Mailing Address - Fax:
Practice Address - Street 1:10 FAIRWAY ST
Practice Address - Street 2:
Practice Address - City:MATTAPAN
Practice Address - State:MA
Practice Address - Zip Code:02126-2153
Practice Address - Country:US
Practice Address - Phone:617-298-2225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-20
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA25105225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist