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Contact Information

CLINICAL PRACTICE OF LECOM INSTITUTE FOR SUCCESSFUL LIVING
16954 CONNEAUT LAKE RD
MEADVILLE, PA16335-3738
 Phone: 814-868-2200
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Geriatric Medicine

207RG0300X 11 Physician/Internal Medicine
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Interventional Cardiology

207RI0011X 11 Physician/Internal Medicine
 

Rural Health

261QR1300X B4[14] Rural Health Clinic
 

Surgery, Foot & Ankle

213ES0103X 48 Podiatry
Indicates primary specialty

NPI Profile & details for CLINICAL PRACTICE OF LECOM INSTITUTE FOR SUCCESSFUL LIVING · (Female)

NPI Number 1447072731
Status Active
Credentials
Entity Individual
Enumeration date 10/28/2024
Last updated 02/03/2025 - More than a year ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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