Organization
SHRINERS HOSPITALS FOR CHILDREN
Active
Other names
Erie Clinic Professional Services
Organization subpart
No
Provider details
NPI number
Authorized official
MARY JANE ANTOON (ADMINISTRATOR)
(814) 875-8733
Entity
Organization
Contact information
Practice address
1645 W 8TH ST, ERIE, PA 16505-5007
(814) 875-8700
Mailing address
PO BOX 8500, LOCKBOX #7642, PHILADELPHIA, PA 19178-7642
Taxonomy
Speciality
Code
Description
License number
State
207XP3100X
Pediatric Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
09/07/2016
Last updated
03/14/2017
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