Provider Demographics
NPI:1891108403
Name:SAINT VINCENT MEDICAL EDUCATION AND RESEARCH INSTITUTE INC
Entity Type:Organization
Organization Name:SAINT VINCENT MEDICAL EDUCATION AND RESEARCH INSTITUTE INC
Other - Org Name:OAK STREET PEDIATRICS
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:814-452-5216
Mailing Address - Street 1:339 W SPRING ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:TITUSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16354-1655
Mailing Address - Country:US
Mailing Address - Phone:814-827-7004
Mailing Address - Fax:814-827-4750
Practice Address - Street 1:339 W SPRING ST
Practice Address - Street 2:SUITE 103
Practice Address - City:TITUSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16354-1655
Practice Address - Country:US
Practice Address - Phone:814-827-7004
Practice Address - Fax:814-827-4750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-11
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty