Provider Demographics
NPI:1437197985
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:
Authorized Official - Last Name:SWIATKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:716-898-6291
Mailing Address - Street 1:462 GRIDER ST FL 3
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14215-3098
Mailing Address - Country:US
Mailing Address - Phone:716-898-3000
Mailing Address - Fax:716-898-5178
Practice Address - Street 1:462 GRIDER ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215-3021
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:2006-06-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1401005H261QE0700X, 273R00000X, 273Y00000X, 276400000X, 324500000X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
No273R00000XHospital UnitsPsychiatric Unit
No273Y00000XHospital UnitsRehabilitation Unit
No276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY08OtherIHA GENERAL ACUTE
NY64OtherIHA IP REHAB
NY65OtherIHA IP PSYCH
NY000000842000OtherBC NECS ALCO
NY000000042002OtherBLUE CROSS IP PSYCH
NY000000840000OtherBC SECS ALCO
NY000000846000OtherBC DTN ALCO
NY000000042001OtherBLUE CROSS ALCO REHAB
NY245863Medicaid
NY66OtherIHA ALCOHOL REHAB
NY000000042000OtherBLUE CROSS GENERAL ACUTE
NY000000042003OtherBLUE CROSS IP REHAB
NY000000042004OtherBC OUTPT ALCO
NY000000042000OtherBLUE CROSS GENERAL ACUTE
NY000000840000OtherBC SECS ALCO
NY245863Medicaid
NY64OtherIHA IP REHAB