Provider Demographics
NPI:1780699439
Name:ONDECK, ERICKA (MS OTRL)
Entity type:Individual
Prefix:
First Name:ERICKA
Middle Name:
Last Name:ONDECK
Suffix:
Gender:F
Credentials:MS OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:668 N CHURCH ST STE 10
Mailing Address - Street 2:
Mailing Address - City:HAZLETON
Mailing Address - State:PA
Mailing Address - Zip Code:18201-3189
Mailing Address - Country:US
Mailing Address - Phone:570-455-0937
Mailing Address - Fax:570-455-0934
Practice Address - Street 1:668 N CHURCH ST STE 10
Practice Address - Street 2:
Practice Address - City:HAZLETON
Practice Address - State:PA
Practice Address - Zip Code:18201-3189
Practice Address - Country:US
Practice Address - Phone:570-455-0937
Practice Address - Fax:570-455-0934
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
818478OtherFIRST PRIORITY
077630Medicare ID - Type Unspecified