Organization Active NPI

David Potoker

  • Rehabilitation Clinic/Center
  • Erie, PA
National Provider Identifier
1851563076
Registry record updated Oct 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
License
SL 00129 L Issued in PA
Legal business name
DAVID POTOKER
Practice address
1611 Peach St
Suite 290
Erie, PA 16501-2109
Phone
(814) 459-9700
Fax
(814) 454-8728
NPI assigned
Mar 27, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
David Potoker, EDD CCC-SLP
Title
Administrator
Phone
(814) 459-9700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X SL 00129 L PA Primary

Addresses

Primary practice location

1611 Peach St
Suite 290
Erie, PA 16501-2109

Mailing address

1611 Peach St
Suite 290
Erie, PA 16501-2109
Phone (814) 459-9700

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1206576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317686400000",
    "number": "1851563076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 PEACH ST",
            "address_2": "SUITE 290",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165012109",
            "telephone_number": "814-459-9700",
            "fax_number": "814-454-8728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 PEACH ST",
            "address_2": "SUITE 290",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165012109",
            "telephone_number": "814-459-9700",
            "fax_number": "814-454-8728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID POTOKER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-27",
        "last_updated": "2011-10-04",
        "status": "A",
        "authorized_official_last_name": "POTOKER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "814-459-9700",
        "authorized_official_credential": "EDD CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "PA",
            "license": "SL 00129 L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.