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General NPI Number Information
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NPI Number | 1811713746
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Entity Type | Organization
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Legal Business Name | LECOM AT ASBURY RIDGE LLC
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Dates
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Enumeration Date | 11/25/2024
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 4855 W RIDGE RD
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City | ERIE
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State | PA
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Zip | 16506-1213
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Country | US
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Telephone | 814-790-1790
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Fax |
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Provider Business Mailing Address
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Address Line | 5535 PEACH ST
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City | ERIE
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State | PA
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Zip | 16509-2603
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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 | JAMES LIN
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Credential | DO
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Telephone | 814-844-2858
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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