Provider Demographics
NPI:1356464382
Name:ERZKUS, CYNTHIA LOU (OTR)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:LOU
Last Name:ERZKUS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MRS
Other - First Name:CYNTHIA
Other - Middle Name:LOU
Other - Last Name:ERZKUS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR
Mailing Address - Street 1:15507 WESTWOOD RD SW
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-5847
Mailing Address - Country:US
Mailing Address - Phone:301-729-1025
Mailing Address - Fax:
Practice Address - Street 1:15507 WESTWOOD RD SW
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-5847
Practice Address - Country:US
Practice Address - Phone:301-729-1025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV876225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist