Basic Information
Provider Information
NPI: 1568587046
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HAMILTON
FirstName: ERIN
MiddleName: M
NamePrefix:  
NameSuffix: I
Credential: COTA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 623 E MAIN ST
Address2:  
City: EVANS CITY
State: PA
PostalCode: 160331206
CountryCode: US
TelephoneNumber: 4126293624
FaxNumber:  
Practice Location
Address1: 9850 OLD PERRY HWY
Address2:  
City: WEXFORD
State: PA
PostalCode: 150909311
CountryCode: US
TelephoneNumber: 4123667900
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/21/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
224Z00000XOP003090LPAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant 

No ID Information.


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