Healthcare Provider Details

I. General information

NPI: 1184518383
Provider Name (Legal Business Name): CEIMOANI BUMRAH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2025
Last Update Date: 09/20/2025
Certification Date: 09/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 STATE ST
ERIE PA
16550-0001
US

IV. Provider business mailing address

3600 FORBES AVE
PITTSBURGH PA
15213-3410
US

V. Phone/Fax

Practice location:
  • Phone: 814-983-6531
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: