Healthcare Provider Details

I. General information

NPI: 1215972716
Provider Name (Legal Business Name): ARMANINI, KOLODYCHAK, & BASILE, L.L.P.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 ZUCK RD
ERIE PA
16506-4932
US

IV. Provider business mailing address

4600 ZUCK RD
ERIE PA
16506-4932
US

V. Phone/Fax

Practice location:
  • Phone: 814-838-2144
  • Fax: 814-838-7227
Mailing address:
  • Phone: 814-838-2144
  • Fax: 814-838-7227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL THOMAS KOLODYCHAK
Title or Position: PARTNER
Credential: D.M.D.
Phone: 814-838-2144