Healthcare Provider Details

I. General information

NPI: 1750986444
Provider Name (Legal Business Name): ERIN SIEGEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2020
Last Update Date: 12/01/2020
Certification Date: 12/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 MAIN ST
CLARION PA
16214-1123
US

IV. Provider business mailing address

PO BOX 131
MARBLE PA
16334-0131
US

V. Phone/Fax

Practice location:
  • Phone: 814-226-7100
  • Fax: 814-223-9181
Mailing address:
  • Phone: 814-221-0465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP452929
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: