Individual
TAYLOR SIPOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2315 MYRTLE ST STE L90, ERIE, PA 16502-4607
(814) 452-7575
Mailing address
26 PARK ST, NORTH EAST, PA 16428-1045
(724) 309-7773
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
MA061779
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15066389
CAQH
—
Enumeration date
11/16/2020
Last updated
01/19/2021
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