Provider Demographics
NPI:1356111579
Name:FEDROFF, ERIKA NICOLE (MOTR)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:NICOLE
Last Name:FEDROFF
Suffix:
Gender:F
Credentials:MOTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 FARM RD
Mailing Address - Street 2:
Mailing Address - City:EWING
Mailing Address - State:NJ
Mailing Address - Zip Code:08638-1412
Mailing Address - Country:US
Mailing Address - Phone:908-883-2151
Mailing Address - Fax:
Practice Address - Street 1:2560 KUSER RD
Practice Address - Street 2:
Practice Address - City:ROBBINSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08691-3480
Practice Address - Country:US
Practice Address - Phone:609-438-9900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00695500225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist