Provider Demographics
NPI:1013979830
Name:HELLER, ERIK JOHN (DPT)
Entity type:Individual
Prefix:DR
First Name:ERIK
Middle Name:JOHN
Last Name:HELLER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 S WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-2755
Mailing Address - Country:US
Mailing Address - Phone:856-251-1812
Mailing Address - Fax:
Practice Address - Street 1:414 TATUM ST
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NJ
Practice Address - Zip Code:08096-3499
Practice Address - Country:US
Practice Address - Phone:856-848-3880
Practice Address - Fax:856-848-4895
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01200700225100000X
PAPT017870225100000X
DEJ1-0001999225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ170686AQVMedicare PIN