Provider Demographics
NPI:1790903698
Name:BARKLEY, ERIK MATTHEW (MS, ATC, NASM-PES)
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:MATTHEW
Last Name:BARKLEY
Suffix:
Gender:M
Credentials:MS, ATC, NASM-PES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 DAY ST
Mailing Address - Street 2:
Mailing Address - City:FREDONIA
Mailing Address - State:NY
Mailing Address - Zip Code:14063-1829
Mailing Address - Country:US
Mailing Address - Phone:716-673-3104
Mailing Address - Fax:
Practice Address - Street 1:49 DODS HALL
Practice Address - Street 2:FREDONIA STATE UNIVERSITY
Practice Address - City:FREDONIA
Practice Address - State:NY
Practice Address - Zip Code:14063
Practice Address - Country:US
Practice Address - Phone:716-673-3104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT-0021342255A2300X
NY2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer