Organization
EASTSIDE MEDICAL CENTER
Active
Other names
Medical Associates of Erie
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS STYN (PRESIDENT)
(814) 866-8468
Entity
Organization
Contact information
Practice address
2625 PARADE ST, ERIE, PA 16504-2809
(814) 452-6382
Mailing address
2625 PARADE ST, ERIE, PA 16504-2809
(814) 452-6382
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207W00000X
Ophthalmology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
208000000X
Pediatrics Physician
—
—
208600000X
Surgery Physician
—
—
208M00000X
Hospitalist Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007045720001
—
PA
Enumeration date
05/01/2007
Last updated
11/07/2007
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