Organization
PENN NORTH CENTERS FOR ADVANCED WOUND CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS E SERENA MD (CEO)
(814) 452-7878
Entity
Organization
Contact information
Practice address
232 W 25TH ST, ERIE, PA 16544-0002
(814) 452-7878
Mailing address
232 W 25TH ST, ERIE, PA 16544-0002
(814) 452-7878
(814) 452-7883
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
—
—
208600000X
Surgery Physician
Primary
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100964725
—
PA
01
—
DC2954
RAILROAD MEDICARE
—
Enumeration date
11/14/2005
Last updated
09/11/2008
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