Provider Demographics
NPI:1376638197
Name:SAINT VINCENT MEDICAL EDUCATION AND RESEARCH INSTITUTE
Entity type:Organization
Organization Name:SAINT VINCENT MEDICAL EDUCATION AND RESEARCH INSTITUTE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATTY
Authorized Official - Middle Name:
Authorized Official - Last Name:BALLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-452-5296
Mailing Address - Street 1:3530 PEACH ST
Mailing Address - Street 2:SUITE LL 1
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16508-2768
Mailing Address - Country:US
Mailing Address - Phone:814-860-5000
Mailing Address - Fax:814-860-5050
Practice Address - Street 1:1910 SASSAFRAS ST
Practice Address - Street 2:SUITE 100
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16502-2716
Practice Address - Country:US
Practice Address - Phone:814-452-5555
Practice Address - Fax:814-452-7610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty