Healthcare Provider Details

I. General information

NPI: 1023064318
Provider Name (Legal Business Name): PATRICK JOHN RECIO DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2010 W 38TH ST UPPR LEVEL
ERIE PA
16508-2004
US

IV. Provider business mailing address

1 LECOM PL
ERIE PA
16505-2571
US

V. Phone/Fax

Practice location:
  • Phone: 814-866-6835
  • Fax: 814-866-6837
Mailing address:
  • Phone: 814-868-2529
  • Fax: 814-868-2522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License NumberOS013283
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: