Organization
OCCUMEDICA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER L LULTSCHIK MD (PRESIDENT)
(814) 835-8935
Entity
Organization
Contact information
Practice address
3939 W RIDGE RD, SUITE A200, ERIE, PA 16506-1879
(814) 835-8935
(814) 835-8408
Mailing address
3939 W RIDGE RD, SUITE A200, ERIE, PA 16506-1879
(814) 835-8935
(814) 835-8408
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
MD050655L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102546321 0002
—
PA
01
—
199632
MEDICARE IND. NO.
PA
01
—
30180152
AMERIHEALTH CARITAS
PA
01
—
3077237
HIGHMARK BLUE SHIELD
PA
01
—
416488
UPMC HEALTH
PA
Enumeration date
12/07/2015
Last updated
12/31/2015
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