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NPI Code Detail

MEDICARE: BAYVIEW NEPHROLOGY, INC.

MEDICARE: BAYVIEW NEPHROLOGY, INC.
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
1207RN0300XNephrology 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 : 1194761643
Entity Type Code : Organization
Provider Name (Legal Business Name) : BAYVIEW NEPHROLOGY, INC.
Provider Business Mailing Address
First Line : 350 E BAYFRONT PKWY
Second Line : UNIT C
City : ERIE
State : PA
Zip : 16507-2410
Country : US
Telephone Number : 814-455-2279
Fax Number : 814-871-1786
Provider Business Practice Location Address
First Line : 350 E BAYFRONT PKWY
Second Line : UNIT C
City : ERIE
State : PA
Zip : 16507-2410
Country : US
Telephone Number : 814-455-2279
Fax Number : 814-871-1786
Authorized Official
Title or Position : PRACTICE MANAGER
Name : MR. DEBRA MARIA DRAGOVAN
Credential : M.B.A.
Telephone Number : 814-455-2279
Provider Enumeration Date : 06/22/2006
Last Update Date : 08/22/2020

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Directions to “BAYVIEW NEPHROLOGY, INC. ” Practice Location

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