Provider Demographics
NPI:1144274895
Name:HERTEL, AARON W (PT)
Entity type:Individual
Prefix:MR
First Name:AARON
Middle Name:W
Last Name:HERTEL
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 1:2147 W 12 ST
Mailing Address - Street 2:STE 1
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-4835
Mailing Address - Country:US
Mailing Address - Phone:814-456-6000
Mailing Address - Fax:814-456-6060
Practice Address - Street 1:2147 W 12 ST
Practice Address - Street 2:STE 1
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16505-4835
Practice Address - Country:US
Practice Address - Phone:814-456-6000
Practice Address - Fax:814-456-6060
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT016791225100000X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1008720060012Medicaid
PA001591340OtherBS
PA108618Medicare UPIN