Provider Demographics
NPI:1558933853
Name:GEDIGIAN, ERIK NICOLAS (PT, DPT)
Entity Type:Individual
Prefix:MR
First Name:ERIK
Middle Name:NICOLAS
Last Name:GEDIGIAN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 AUDACE AVE APT 307
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-3394
Mailing Address - Country:US
Mailing Address - Phone:561-573-3743
Mailing Address - Fax:
Practice Address - Street 1:7410 W BOYNTON BEACH BLVD STE A11
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-6157
Practice Address - Country:US
Practice Address - Phone:561-731-0163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-15
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist