Provider Demographics
NPI:1295840106
Name:AITKEN, ERICA ZIMMERMAN (DPT, SCS, ATC, CSCS)
Entity type:Individual
Prefix:DR
First Name:ERICA
Middle Name:ZIMMERMAN
Last Name:AITKEN
Suffix:
Gender:F
Credentials:DPT, SCS, ATC, CSCS
Other - Prefix:DR
Other - First Name:ERICA
Other - Middle Name:LEE
Other - Last Name:ZIMMERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT, SCS, ATC, CSCS
Mailing Address - Street 1:405 MAIN ST STE 6
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-3135
Mailing Address - Country:US
Mailing Address - Phone:212-256-0445
Mailing Address - Fax:212-510-8018
Practice Address - Street 1:405 MAIN ST STE 6
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTON
Practice Address - State:NY
Practice Address - Zip Code:11050-3135
Practice Address - Country:US
Practice Address - Phone:212-256-0445
Practice Address - Fax:212-510-8018
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027800-01225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400056501Medicare PIN