Provider Demographics
NPI:1780021659
Name:JAYNE, ERIKA K (DPT)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:K
Last Name:JAYNE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13A MAIN ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-1941
Mailing Address - Country:US
Mailing Address - Phone:973-726-7400
Mailing Address - Fax:973-726-7440
Practice Address - Street 1:4473 PINE RIDGE DRIVE BUS
Practice Address - Street 2:
Practice Address - City:BUSHKILL
Practice Address - State:PA
Practice Address - Zip Code:18324-1832
Practice Address - Country:US
Practice Address - Phone:609-903-4122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-31
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01496200225100000X
PAPT024152225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPT024152OtherPT LICENSE