Healthcare Provider Details

I. General information

NPI: 1538165493
Provider Name (Legal Business Name): DAVID C. LESSESKI DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2005
Last Update Date: 10/02/2020
Certification Date: 10/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 W 23RD ST STE 202
ERIE PA
16502-2858
US

IV. Provider business mailing address

145 W 23RD ST STE 202
ERIE PA
16502-2858
US

V. Phone/Fax

Practice location:
  • Phone: 814-452-5081
  • Fax: 814-452-7918
Mailing address:
  • Phone: 814-452-5081
  • Fax: 814-452-7918

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberOS007417L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: