Basic Information
| Provider Information | |||||||||
| NPI: | 1417961236 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BERK | ||||||||
| FirstName: | ERIN | ||||||||
| MiddleName: | MORAN | ||||||||
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| Credential: | DPT | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | MORAN | ||||||||
| OtherFirstName: | ERIN | ||||||||
| OtherMiddleName: | FLINT | ||||||||
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| OtherCredential: | DPT | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 11240 WAPLES MILL ROAD | ||||||||
| Address2: | SUITE 403 | ||||||||
| City: | FAIRFAX | ||||||||
| State: | VA | ||||||||
| PostalCode: | 22030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7033854707 | ||||||||
| FaxNumber: | 7036914933 | ||||||||
| Practice Location | |||||||||
| Address1: | 8320 OLD COURTHOUSE RD | ||||||||
| Address2: | SUITE 401 | ||||||||
| City: | VIENNA | ||||||||
| State: | VA | ||||||||
| PostalCode: | 221823831 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7032887864 | ||||||||
| FaxNumber: | 7032887869 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/28/2006 | ||||||||
| LastUpdateDate: | 12/11/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 2305204404 | VA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.