Provider Demographics
NPI:1366891368
Name:INSTITUTE ON HEALTHCARE DIRECTIVES
Entity type:Organization
Organization Name:INSTITUTE ON HEALTHCARE DIRECTIVES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CMO
Authorized Official - Prefix:DR
Authorized Official - First Name:FERDINANDO
Authorized Official - Middle Name:L
Authorized Official - Last Name:MIRARCHI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:814-490-6584
Mailing Address - Street 1:4885 EQUESTRIAN DR
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-6617
Mailing Address - Country:US
Mailing Address - Phone:814-490-6584
Mailing Address - Fax:
Practice Address - Street 1:900 STATE ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16501-1419
Practice Address - Country:US
Practice Address - Phone:814-490-6584
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-09
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS009857L207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2284068Medicaid
PAG91710Medicare UPIN