Provider Demographics
NPI:1124570866
Name:VANECK, ERICA (MS, OTR/L)
Entity Type:Individual
Prefix:MS
First Name:ERICA
Middle Name:
Last Name:VANECK
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 VALLEY VIEW DR
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-2105
Mailing Address - Country:US
Mailing Address - Phone:201-934-3411
Mailing Address - Fax:
Practice Address - Street 1:4 VALLEY VIEW DR
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-2105
Practice Address - Country:US
Practice Address - Phone:201-669-1880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-28
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00746400225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist