Organization
MEDICAL ASSOCIATES OF ERIE
Active
Parent organization
MEDICAL ASSOCIATES OF ERIE
Other names
LECOM Institute for Behavioral Health
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDICAL ASSOCIATES OF ERIE
Authorized official
NICOLE GROSSI (CREDENTIALING SPECIALIST)
(814) 868-2507
Entity
Organization
Contact information
Practice address
4740 PEACH ST, ERIE, PA 16509-2008
(814) 520-5652
(814) 616-8002
Mailing address
1 LECOM PL, ERIE, PA 16505-2571
(814) 868-2507
(814) 868-2522
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1010664580025
—
PA
Enumeration date
02/17/2020
Last updated
02/19/2020
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