Provider Demographics
NPI:1104341056
Name:RODORMER, ERIKA (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:ERIKA
Middle Name:
Last Name:RODORMER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 HOYT ST
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:CT
Mailing Address - Zip Code:06820-2014
Mailing Address - Country:US
Mailing Address - Phone:973-908-5692
Mailing Address - Fax:203-869-7654
Practice Address - Street 1:45 GROVE ST STE H
Practice Address - Street 2:
Practice Address - City:NEW CANAAN
Practice Address - State:CT
Practice Address - Zip Code:06840-5330
Practice Address - Country:US
Practice Address - Phone:973-908-5692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-11
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT010535225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist