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NPI Code Detail

MEDICARE: EASTSIDE MEDICAL CENTER

MEDICARE: EASTSIDE MEDICAL CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician
2208000000XPediatrics Physician
3208600000XSurgery Physician
4208M00000XHospitalist Physician
5207X00000XOrthopaedic Surgery Physician
6207V00000XObstetrics & Gynecology Physician
7207W00000XOphthalmology Physician
8207Q00000XFamily Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1992926786
Entity Type Code : Organization
Provider Name (Legal Business Name) : EASTSIDE MEDICAL CENTER
Provider Business Mailing Address
First Line : 2625 PARADE ST
Second Line :
City : ERIE
State : PA
Zip : 16504-2809
Country : US
Telephone Number : 814-452-6382
Fax Number :
Provider Business Practice Location Address
First Line : 2625 PARADE ST
Second Line :
City : ERIE
State : PA
Zip : 16504-2809
Country : US
Telephone Number : 814-452-6382
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DENNIS STYN
Credential :
Telephone Number : 814-866-8468
Provider Enumeration Date : 05/01/2007
Last Update Date : 11/07/2007

Similar Medicare Providers

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Practice Location Address:
2625 PARADE ST
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16504-2809
Practice Phone: 814-452-6383
Practice Fax: 814-452-1427
1972574390 — DAVID FOX DO
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1740245844 — DR. STEVEN HABUSTA D.O.
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1609833573 — DR. ROSS ANTHONY SNOW MD
Practice Location Address:
2625 PARADE ST
ERIE, PA
16504-2809
Practice Phone: 814-452-6383
Practice Fax: 814-452-1427
1437211307 — GARY MICHAEL RITTEN MD
Practice Location Address:
2625 PARADE ST
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16504-2809
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Practice Fax: 814-452-1427
1346368883 — MEDICAL ASSOCIATES OF ERIE
Practice Location Address:
2625 PARADE ST
ERIE, PA
16504-2809
Practice Phone: 814-452-6383
Practice Fax:

Directions to “EASTSIDE MEDICAL CENTER ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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