Provider Demographics
NPI:1417404864
Name:HEYER, ERIC
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:HEYER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 THOMPSON AVE
Mailing Address - Street 2:
Mailing Address - City:LEONARDO
Mailing Address - State:NJ
Mailing Address - Zip Code:07737-1418
Mailing Address - Country:US
Mailing Address - Phone:732-673-6375
Mailing Address - Fax:
Practice Address - Street 1:61 THOMPSON AVE
Practice Address - Street 2:
Practice Address - City:LEONARDO
Practice Address - State:NJ
Practice Address - Zip Code:07737-1418
Practice Address - Country:US
Practice Address - Phone:732-673-6375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services