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General NPI Number Information
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NPI Number | 1790865145
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Entity Type | Organization
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Legal Business Name | ERIE COUNTY PUBLIC HEALTH LABORATORY
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 05/03/2023
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Provider Practice Location Address
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Address Line | 503 KENSINGTON AVE BUILDING AA, ROOM AA19
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City | BUFFALO
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State | NY
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Zip | 14214-2804
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Country | US
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Telephone | 716-898-6100
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Fax | 716-898-6110
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Provider Business Mailing Address
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Address Line | 503 KENSINGTON AVE BUILDING AA, ROOM AA19
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City | BUFFALO
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State | NY
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Zip | 14214-2804
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Country | US
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Telephone | 716-898-6100
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Fax | 716-898-6110
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Authorized Official
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Title or Position | ADMINISTRATIVE COORD
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Name | MS. CARLEEN M. POPE
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Credential | M.S., M.P.H.
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Telephone | 716-898-6100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | PFI1980
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License Number State | NY
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