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General NPI Number Information
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NPI Number | 1013966548
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Entity Type | Individual
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Provider Name | CECILIA T. URQUICO M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/10/2006
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Last Update Date | 12/21/2012
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Provider Practice Location Address
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Address Line | 2501 W 12TH ST SUITE 1
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City | ERIE
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State | PA
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Zip | 16505-4527
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Country | US
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Telephone | 814-806-1144
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Fax | 814-833-0659
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Provider Business Mailing Address
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Address Line | PO BOX 644850
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City | PITTSBURGH
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State | PA
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Zip | 15264-4850
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Country | US
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Telephone | 412-937-8887
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Fax | 412-937-9221
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD435122
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License Number State | PA
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