Healthcare Provider Details

I. General information

NPI: 1851467575
Provider Name (Legal Business Name): JOSEPH JAMES SIVAK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2910 STATE ST
ERIE PA
16508-1832
US

IV. Provider business mailing address

2910 STATE ST
ERIE PA
16508-1832
US

V. Phone/Fax

Practice location:
  • Phone: 814-454-5686
  • Fax: 814-454-8946
Mailing address:
  • Phone: 814-454-5686
  • Fax: 814-454-8946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME117834
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD449533
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: