Provider Demographics
NPI:1396932810
Name:SAINT VINCENT PEDIATRIC ECHO
Entity type:Organization
Organization Name:SAINT VINCENT PEDIATRIC ECHO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CONSTANCE
Authorized Official - Middle Name:ANGELA
Authorized Official - Last Name:BONTEMPO
Authorized Official - Suffix:
Authorized Official - Credentials:FACHE
Authorized Official - Phone:814-452-5111
Mailing Address - Street 1:232 W 25TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16544-0002
Mailing Address - Country:US
Mailing Address - Phone:814-452-5000
Mailing Address - Fax:
Practice Address - Street 1:232 W 25TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16544-0002
Practice Address - Country:US
Practice Address - Phone:814-452-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-28
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric CardiologyGroup - Single Specialty