Provider Demographics
NPI:1215972716
Name:ARMANINI, KOLODYCHAK, & BASILE, L.L.P.
Entity type:Organization
Organization Name:ARMANINI, KOLODYCHAK, & BASILE, L.L.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:KOLODYCHAK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:814-838-2144
Mailing Address - Street 1:4600 ZUCK RD
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-4932
Mailing Address - Country:US
Mailing Address - Phone:814-838-2144
Mailing Address - Fax:814-838-7227
Practice Address - Street 1:4600 ZUCK RD
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-4932
Practice Address - Country:US
Practice Address - Phone:814-838-2144
Practice Address - Fax:814-838-7227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
V0V08OOtherUPMC HEALTH PLAN IDENTIFICATION
000950549OtherHIGHMARK IDENTIFICATION
V0V08OOtherUPMC HEALTH PLAN IDENTIFICATION