Provider Demographics
NPI:1285840090
Name:ERIE COUNTY MEDICAL CENTER CORPORATION
Entity Type:Organization
Organization Name:ERIE COUNTY MEDICAL CENTER CORPORATION
Other - Org Name:PROFESSIONAL BILLING
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SUE
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCCARTHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-898-5931
Mailing Address - Street 1:462 GRIDER ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14215-3021
Mailing Address - Country:US
Mailing Address - Phone:716-898-5931
Mailing Address - Fax:716-898-5178
Practice Address - Street 1:462 GRIDER ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215-3021
Practice Address - Country:US
Practice Address - Phone:716-898-5931
Practice Address - Fax:716-898-5178
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ERIE COUNTY MEDICAL CENTER CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-16
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1401005H261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7010AAMedicare ID - Type UnspecifiedCRNA
NY7009AAMedicare ID - Type UnspecifiedCARDIOLOGISTS
NY7008AAMedicare ID - Type UnspecifiedCLINICS