Healthcare Provider Details

I. General information

NPI: 1770996308
Provider Name (Legal Business Name): SAINT VINCENT MEDICAL EDUCATION AND RESEARCH INSTITUTE
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

150 W CENTRAL AVE SUITE 3
TITUSVILLE PA
16354-1724
US

IV. Provider business mailing address

150 W CENTRAL AVE SUITE 3
TITUSVILLE PA
16354-1724
US

V. Phone/Fax

Practice location:
  • Phone: 814-827-3400
  • Fax: 814-827-3556
Mailing address:
  • Phone: 814-827-3400
  • Fax: 814-827-3556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: THOMAS MURPHY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 814-452-5216