MEDICARE: ROMAN MACK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	MA001069L	PA

General Provider Information

NPI Number	:	1831178839
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROMAN MACK

Provider Business Mailing Address
First Line	:	3330 PEACH ST STE 106B
Second Line	:	SUITE 106B
City	:	ERIE
State	:	PA
Zip	:	16508-2771
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3330 PEACH ST STE 106B
Second Line	:	SUITE 106B
City	:	ERIE
State	:	PA
Zip	:	16508-2771
Country	:	US
Telephone Number	:	814-877-5570
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/10/2006
Last Update Date	:	04/06/2021

Similar Medicare Providers

1992650063 — MACKENZIE LOIS MUSTIN CRNP
Practice Location Address:

3330 PEACH ST STE 106
ERIE, PA
16508-2771

Practice Phone: 814-877-8586
Practice Fax:

1710986534 — DANIEL BARBERO
Practice Location Address:

3330 PEACH ST STE 106B , SUITE 106B
ERIE, PA
16508-2771

Practice Phone: 814-877-5570
Practice Fax:

1609885706 — KATHRYNE L BUEGE D.O.
Practice Location Address:

3330 PEACH ST STE 106B
ERIE, PA
16508-2771

Practice Phone: 814-877-5570
Practice Fax: 814-877-5571

1841457579 — REGIONAL HEALTH SERVICES INC.
Practice Location Address:

3330 PEACH STREET , SUITE 106
ERIE, PA
16508-2771

Practice Phone: 814-877-5500
Practice Fax: 814-877-5508

1023274230 — JOSHUA BRITTEN
Practice Location Address:

3330 PEACH ST STE 107
ERIE, PA
16508-2771

Practice Phone: 814-877-3668
Practice Fax:

1043681919 — MRS. VICTORIA CAMILLERI CRNP
Practice Location Address:

3330 PEACH ST STE 106
ERIE, PA
16508-2771

Practice Phone: 814-877-5570
Practice Fax: 814-877-5571

Directions to “ ROMAN MACK ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.