Provider Demographics
NPI:1528233616
Name:ERIE COUNTY MEDICAL CENTER CORPORATION
Entity type:Organization
Organization Name:ERIE COUNTY MEDICAL CENTER CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:T
Authorized Official - Last Name:SWIATKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:716-898-6291
Mailing Address - Street 1:820 US ROUTE 9
Mailing Address - Street 2:NORTHWAY PLAZA SUITE 4F
Mailing Address - City:QUEENSBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12804-1766
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:462 GRIDER ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215-3098
Practice Address - Country:US
Practice Address - Phone:716-898-3000
Practice Address - Fax:716-898-5178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2024-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03045416Medicaid
NYDD5582OtherRAILROAD MEDICARE
NY7008AAMedicare PIN