Provider Demographics
NPI:1588029276
Name:SAINT VINCENT MEDICAL EDUCATION AND RESEARCH INSTITUTE
Entity Type:Organization
Organization Name:SAINT VINCENT MEDICAL EDUCATION AND RESEARCH INSTITUTE
Other - Org Name:SAINT VINCENT CENTER FOR NUTRITION AND DIABETES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-452-5616
Mailing Address - Street 1:1910 SASSAFRAS ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16502-2716
Mailing Address - Country:US
Mailing Address - Phone:814-452-5772
Mailing Address - Fax:814-452-7818
Practice Address - Street 1:145 W 23RD ST
Practice Address - Street 2:SUITE 302A
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16502-2858
Practice Address - Country:US
Practice Address - Phone:814-452-7354
Practice Address - Fax:814-452-7359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-22
Last Update Date:2015-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, MetabolicGroup - Single Specialty