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General NPI Number Information
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NPI Number | 1740944966
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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 | 10/25/2021
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Last Update Date | 10/25/2021
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Provider Practice Location Address
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Address Line | 2820 W 12TH ST
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City | ERIE
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State | PA
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Zip | 16505-4204
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Country | US
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Telephone | 814-833-8800
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Fax | 814-833-2079
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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 |
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine 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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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