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Organization
MEDICAL ASSOCIATES OF ERIE
Active
Organization
MEDICAL ASSOCIATES OF ERIE
Active
Parent organization
MEDICAL ASSOCIATES OF ERIE
Other names
Plaza 18 Behavioral Health
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDICAL ASSOCIATES OF ERIE
Authorized official
NICOLE GROSSI (CREDENTIALING SPECIALIST)
(814) 868-2507
Entity
Organization
Contact information
Practice address
537 W 18TH ST, ERIE, PA 16502-1722
(814) 456-1009
(814) 454-6051
Mailing address
1 LECOM PL, ERIE, PA 16505-2571
(814) 868-2507
(814) 868-2522
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
NULL
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
—
Other
Enumeration date
02/17/2020
Last updated
02/17/2020
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