Organization
PODIATRY ASSOCIATES OF ERIE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD D. DIBACCO DPM (PRESIDENT)
(814) 864-4874
Entity
Organization
Contact information
Practice address
4402 PEACH ST, ERIE, PA 16509-1358
(814) 864-4874
(814) 864-4877
Mailing address
4402 PEACH ST, ERIE, PA 16509-1358
(814) 864-4874
(814) 864-4877
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000501005-0001
—
PA
05
—
0241581
—
OH
Enumeration date
04/04/2007
Last updated
08/22/2020
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