Organization
LAKE ERIE ANESTHESIA OF PA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KIMBERLY J FITZPATRICK CRNA (PRESIDENT)
(814) 835-2298
Entity
Organization
Contact information
Practice address
5529 SHADYBROOK DR, ERIE, PA 16506-6508
(814) 835-2298
Mailing address
5529 SHADYBROOK DR, ERIE, PA 16506-6508
(814) 835-2298
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0074658
—
OH
Enumeration date
02/21/2011
Last updated
05/08/2013
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