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NPI Code Detail

MEDICARE: SAINT VINCENT MEDICAL EDUCATION AND RESEARCH INSTITUTE

MEDICARE: SAINT VINCENT MEDICAL EDUCATION AND RESEARCH INSTITUTE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207QS0010XSports Medicine (Family Medicine) Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093801482
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAINT VINCENT MEDICAL EDUCATION AND RESEARCH INSTITUTE
Provider Business Mailing Address
First Line : 3530 PEACH ST
Second Line : SUITE LL1
City : ERIE
State : PA
Zip : 16508-2768
Country : US
Telephone Number : 814-860-5000
Fax Number : 814-860-5050
Provider Business Practice Location Address
First Line : 189 E MAIN ST
Second Line :
City : WESTFIELD
State : NY
Zip : 14787-1104
Country : US
Telephone Number : 716-793-2352
Fax Number : 716-793-2312
Authorized Official
Title or Position : DIRECTOR OF OPERATIONS
Name : PATTY BALLMAN
Credential :
Telephone Number : 814-452-5296
Provider Enumeration Date : 10/05/2006
Last Update Date : 02/29/2008

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Directions to “SAINT VINCENT MEDICAL EDUCATION AND RESEARCH INSTITUTE ” Practice Location

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