LECOM SENIOR LIVING CENTER (NPI# 1891237665) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891237665 |
| Entity Type | Organization |
| Organization Name | LECOM SENIOR LIVING CENTER |
| Other Organization Name | MILLCREEK MANOR |
| Practice Address |
5535 Peach Street Erie PA 16509-8528 |
| Practice Telephone | 8148683820 |
| Practice Fax Number | 8148683887 |
| Mailing Telephone | 8148683820 |
| Mailing Fax Number | 8148683887 |
| Enumeration Date | 2016-11-10 |
| Last Update Date | 2016-11-10 |
| Authorized Official Name | DR. MELANIE RAE TITZEL (DIRECTOR OF OPERATIONS) |
| Authorized Official Telephone | 81486833812 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | MILLCREEK MANOR |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133NN1002X |
Nutritionist Specialization: Nutrition, Education |
806473 | Dietary & Nutritional Service Providers |
| Other Name | Type Code |
|---|---|
| Millcreek Manor | Former Legal Business Name - Organization |
| Street Address |
5535 PEACH STREET |
| City | ERIE |
| State | PA |
| Zip Code | 16509-8528 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780981621 | Debra K Brown | Social Worker | 5535 Peach Street, Lecom Senior Living Center, Erie, PA 16509 | 2011-02-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598243073 | Austin Dudenhoefer | Physical Therapist | 8270 Peach St Ste 400, Erie, PA 16509 | 2018-08-06 |
| 1770092884 | Latasha Marie Phillips | Social Worker | 5100 Peach Street, Erie, PA 16509 | 2017-09-21 |
| 1932621307 | Mitchell Meagher | Internal Medicine | 5515 Peach St., Attn: Medical Education, Erie, PA 16509 | 2017-07-07 |
| 1760903702 | Tricia Lee Cubitt | Social Worker | 4756 Springview Drive, Apartment 310, Erie, PA 16509 | 2017-06-29 |
| 1790191617 | Ashley Russell | Physical Therapy Assistant | 1267 South Hill Road, Erie, PA 16509 | 2014-07-11 |
| 1295084085 | Michael David Mccafferty | Internal Medicine | 5332 Rome Court Drive, 301, Erie, PA 16509 | 2012-09-07 |
| 1427303619 | Michelle Mary Dillaene Tobin | Social Worker | 828 W. Gore Road, Erie, PA 16509 | 2012-07-13 |
| 1962761411 | Moshood B Martins | Dentist | 7040 Peach Street, Erie, PA 16509 | 2012-05-03 |
| 1770854549 | Peach Street Dental & Dentures, PC. | Dentist | 7040 Peach St, Erie, PA 16509 | 2012-01-25 |
| 1881989515 | Richard R Sambuchino | Dentist | 4944 Peach Street, Erie, PA 16509 | 2011-06-10 |
| Find all providers in zip 16509 | ||||
| Taxonomy Code | 133NN1002X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Nutritionist |
| Specialization | Nutrition, Education |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295370294 | Miranda Ortolani | Nutritionist | 875 N Easton Rd Ste 6b, Doylestown, PA 18902-1026 | 2019-11-13 |
| 1063997138 | Laura Jean Zervos | Nutritionist | 5417 Enterprise Blvd, Bethel Park, PA 15102-2691 | 2018-09-25 |
| 1689183022 | Anita Vasko | Nutritionist | 441 Barker Dr, West Chester, PA 19380-6341 | 2017-09-28 |
| 1013430750 | Judith Ann Ring | Nutritionist | 1003 W 9th Ave Ste E, King of Prussia, PA 19406-1210 | 2017-07-25 |
| 1730548751 | Susanna Nolt | Nutritionist | 774 Fairmont Ave, Mohnton, PA 19540-1338 | 2016-02-18 |
| 1619335676 | Ricky Jacobson | Nutritionist | 280 Pennbrook Pkwy, Lansdale, PA 19446-3843 | 2016-02-05 |
| 1336574532 | Megan Neiman | Nutritionist | 6613 Birchwood Ave, Pittsburgh, PA 15217-3001 | 2013-09-06 |
| 1063856532 | Lovelovinglove Inc | Nutritionist | 704 Cedar Ave, Yeadon, PA 19050-3304 | 2013-04-26 |
| 1518227891 | Ramona J Fasula | Nutritionist | 910 Providence Rd, Secane, PA 19018-3640 | 2012-05-21 |
| 1063714160 | Cynthia Ann Dale | Nutritionist | 838b Market Street, Meadville, PA 16335 | 2010-11-22 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.