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General NPI Number Information
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NPI Number | 1700020021
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Entity Type | Organization
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Legal Business Name | MEDICAL ASSOCIATES OF ERIE
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Dates
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Enumeration Date | 04/30/2009
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Last Update Date | 12/05/2023
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Provider Practice Location Address
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Address Line | 5401 PEACH ST STE 3300
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City | ERIE
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State | PA
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Zip | 16509-2601
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Country | US
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Telephone | 814-868-7840
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Fax | 814-868-2139
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Provider Business Mailing Address
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Address Line | 1 LECOM PL
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City | ERIE
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State | PA
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Zip | 16505-2571
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Country | US
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Telephone | 814-528-9732
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Fax | 814-528-9722
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | JEAN NEJMAN
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Credential |
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Telephone | 814-868-2507
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | OS08877L
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License Number State | PA
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