Provider Demographics
NPI:1073841896
Name:RODRIN, ERWIN A (PT)
Entity Type:Individual
Prefix:
First Name:ERWIN
Middle Name:A
Last Name:RODRIN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 MAYWOOD CT
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-4107
Mailing Address - Country:US
Mailing Address - Phone:973-279-2323
Mailing Address - Fax:973-279-7551
Practice Address - Street 1:100 HAMILTON PLZ FL 3
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07505-2186
Practice Address - Country:US
Practice Address - Phone:973-279-2323
Practice Address - Fax:973-279-7551
Is Sole Proprietor?:No
Enumeration Date:2009-12-07
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01336300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist