Basic Information
Provider Information
NPI: 1285294470
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHEICK
FirstName: EMMA
MiddleName: R
NamePrefix:  
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2315 MYRTLE ST STE 190
Address2:  
City: ERIE
State: PA
PostalCode: 165024604
CountryCode: US
TelephoneNumber: 8144537767
FaxNumber: 8144546667
Practice Location
Address1: 2315 MYRTLE ST STE 190
Address2:  
City: ERIE
State: PA
PostalCode: 165024604
CountryCode: US
TelephoneNumber: 8144537767
FaxNumber: 8144546667
Other Information
ProviderEnumerationDate: 06/19/2019
LastUpdateDate: 10/05/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/05/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000XMA060725PAY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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