Healthcare Provider Details

I. General information

NPI: 1275537722
Provider Name (Legal Business Name): MICHAEL N PALLONE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2005
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2820 W 12TH ST
ERIE PA
16505-4204
US

IV. Provider business mailing address

1 LECOM PL
ERIE PA
16505-2571
US

V. Phone/Fax

Practice location:
  • Phone: 814-833-8800
  • Fax:
Mailing address:
  • Phone: 814-868-2507
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD057226L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD90260
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: