Provider Demographics
NPI:1114257680
Name:CEDOR, ERIC (DPT)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:
Last Name:CEDOR
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 1:111 VETERANS MEMORIAL BLVD
Mailing Address - Street 2:SUITE 470
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-3028
Mailing Address - Country:US
Mailing Address - Phone:504-834-9259
Mailing Address - Fax:504-834-9281
Practice Address - Street 1:1201 OCHSNER BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-8147
Practice Address - Country:US
Practice Address - Phone:985-801-7145
Practice Address - Fax:985-801-7146
Is Sole Proprietor?:No
Enumeration Date:2010-01-06
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA07747R225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist