Healthcare Provider Details

I. General information

NPI: 1134859309
Provider Name (Legal Business Name): SANDRA CAROLA HERRERA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2022
Last Update Date: 09/14/2025
Certification Date: 09/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4950 BUFFALO RD
ERIE PA
16510-2304
US

IV. Provider business mailing address

261 E 33RD ST
ERIE PA
16504-1550
US

V. Phone/Fax

Practice location:
  • Phone: 814-899-7000
  • Fax: 814-899-0334
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS024856
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: