Organization
PEDIATRIC CARE CENTER OF ERIE, PC
Active
Other names
Pediatric Care Center of Erie
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAVI CHEKKA MD (PRESIDENT)
(814) 454-2891
Entity
Organization
Contact information
Practice address
1611 PEACH ST STE 300, ERIE, PA 16501-2122
(814) 454-2891
Mailing address
1611 PEACH ST STE 300, ERIE, PA 16501-2122
(814) 454-2891
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD038253L
PA
208000000X
Pediatrics Physician
MD419696
PA
208000000X
Pediatrics Physician
Primary
MD440507
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1467626283
—
PA
05
—
1770550063
—
PA
05
—
1811976020
—
PA
01
—
MD440507
PA STATE LICENSE
PA
Enumeration date
02/08/2018
Last updated
10/01/2020
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