Healthcare Provider Details
I. General information
NPI: 1891108403
Provider Name (Legal Business Name): SAINT VINCENT MEDICAL EDUCATION AND RESEARCH INSTITUTE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/11/2014
Last Update Date: 06/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
339 W SPRING ST SUITE 103
TITUSVILLE PA
16354-1655
US
IV. Provider business mailing address
339 W SPRING ST SUITE 103
TITUSVILLE PA
16354-1655
US
V. Phone/Fax
- Phone: 814-827-7004
- Fax: 814-827-4750
- Phone: 814-827-7004
- Fax: 814-827-4750
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
THOMAS
MURPHY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 814-452-5216