Provider Demographics
NPI:1952402554
Name:SAINT VINCENT MEDICAL EDUCATION AND RESEARCH INSTITUTE
Entity Type:Organization
Organization Name:SAINT VINCENT MEDICAL EDUCATION AND RESEARCH INSTITUTE
Other - Org Name:CHILDREN'S HEALTH CARE WEST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
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 LL1
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16508-2768
Mailing Address - Country:US
Mailing Address - Phone:814-860-5036
Mailing Address - Fax:814-860-5063
Practice Address - Street 1:2501 W 12TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16505-4527
Practice Address - Country:US
Practice Address - Phone:814-835-4838
Practice Address - Fax:814-835-6938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty