Healthcare Provider Details

I. General information

NPI: 1588100853
Provider Name (Legal Business Name): SAINT VINCENT MEDICAL EDUCATION AND RESEARCH INST. INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2017
Last Update Date: 10/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 W 23RD ST STE 303
ERIE PA
16502-2858
US

IV. Provider business mailing address

153 E 13TH ST STE 1300
ERIE PA
16503-1035
US

V. Phone/Fax

Practice location:
  • Phone: 814-452-7915
  • Fax: 814-452-7915
Mailing address:
  • Phone: 814-452-5216
  • Fax: 814-452-7005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: THOMAS MURPHY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 814-452-5310