NPIMap

Organization Active NPI

Gideon M. Roquiz

  • Physiological Laboratory
  • Erie, PA
National Provider Identifier
1235397795
Registry record updated Jun 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physiological LaboratoryTaxonomy code 293D00000X
Legal business name
GIDEON M. ROQUIZ
Practice address
5205 Coventry Dr
Erie, PA 16506-6107
Phone
(814) 835-2362
NPI assigned
May 30, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Gideon Maniago RoquizNPI 1124169644
Title
Owner
Phone
(814) 835-2362

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physiological Laboratory 293D00000X Primary

Addresses

Primary practice location

5205 Coventry Dr
Erie, PA 16506-6107

Mailing address

5205 Coventry Dr
Erie, PA 16506-6107
Phone (814) 835-2362

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1212105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212451200000",
    "number": "1235397795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5205 COVENTRY DR",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165066107",
            "telephone_number": "814-835-2362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5205 COVENTRY DR",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165066107",
            "telephone_number": "814-835-2362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIDEON M. ROQUIZ",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-30",
        "last_updated": "2008-06-03",
        "status": "A",
        "authorized_official_last_name": "ROQUIZ",
        "authorized_official_first_name": "GIDEON",
        "authorized_official_middle_name": "MANIAGO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "814-835-2362"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.