Healthcare Provider Details

I. General information

NPI: 1609955533
Provider Name (Legal Business Name): ERIE COUNTY MEDICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8300 WEST RIDGE RD
GIRARD PA
16417
US

IV. Provider business mailing address

8300 WEST RIDGE RD
GIRARD PA
16417
US

V. Phone/Fax

Practice location:
  • Phone: 814-474-5521
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. EARDLY WICKRAMASINGHE
Title or Position: PHYSICIAN/OWNER
Credential: MD
Phone: 814-474-5521