Provider Demographics
NPI:1982617114
Name:ERDEN FIKRI, M.D., P.C.
Entity Type:Organization
Organization Name:ERDEN FIKRI, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERDEN
Authorized Official - Middle Name:
Authorized Official - Last Name:FIKRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-535-3571
Mailing Address - Street 1:353 MARKET ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15901-1711
Mailing Address - Country:US
Mailing Address - Phone:814-535-3571
Mailing Address - Fax:814-535-3572
Practice Address - Street 1:353 MARKET ST
Practice Address - Street 2:SUITE 103
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15901-1711
Practice Address - Country:US
Practice Address - Phone:814-535-3571
Practice Address - Fax:814-535-3572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD033901L208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006409940001Medicaid
121675Medicare PIN