Provider Demographics
NPI:1699742445
Name:KOESTER, ERICA LYNN (PT, DPT, LMT)
Entity type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:LYNN
Last Name:KOESTER
Suffix:
Gender:F
Credentials:PT, DPT, LMT
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:LYNN
Other - Last Name:TURSCHMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, LMT
Mailing Address - Street 1:2120 SHOMA DR
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33414-4336
Mailing Address - Country:US
Mailing Address - Phone:516-662-2009
Mailing Address - Fax:
Practice Address - Street 1:2120 SHOMA DR
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33414-4336
Practice Address - Country:US
Practice Address - Phone:516-666-2009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-01
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024829-1225100000X
NY70138225700000X
FL32720225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY900061612OtherMAGNACARE
NYQ21D91Medicare ID - Type UnspecifiedPHYSICAL THERAPY