Provider Demographics
NPI:1982604963
Name:ACRI, ERCOL OSCAR JR (DC)
Entity Type:Individual
Prefix:DR
First Name:ERCOL
Middle Name:OSCAR
Last Name:ACRI
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 N FREDERICK ST
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-6237
Mailing Address - Country:US
Mailing Address - Phone:717-691-8155
Mailing Address - Fax:717-691-0370
Practice Address - Street 1:202 N FREDERICK ST
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-6237
Practice Address - Country:US
Practice Address - Phone:717-691-8155
Practice Address - Fax:717-691-0370
Is Sole Proprietor?:No
Enumeration Date:2005-07-30
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003104L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA438365OtherHIGHMARK (BLU SHIELD)
PA9843585OtherAETNA PROV NUMBER
PA9843585OtherAETNA PROV NUMBER