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General NPI Number Information
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NPI Number | 1053573915
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Entity Type | Organization
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Legal Business Name | ERIE MEDICAL & REHAB CENTER INC
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Dates
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Enumeration Date | 07/01/2008
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Last Update Date | 07/21/2011
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Provider Practice Location Address
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Address Line | 3901 LIBERTY ST
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City | ERIE
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State | PA
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Zip | 16509-1689
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Country | US
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Telephone | 814-866-5559
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Fax |
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Provider Business Mailing Address
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Address Line | 3901 LIBERTY ST
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City | ERIE
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State | PA
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Zip | 16509-1689
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN A LUPO
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Credential | D.C.
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Telephone | 814-866-5559
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | OS008755L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS008755L
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | DC005039L
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC005039L
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License Number State | PA
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