| State Street Primary Care | |
|
1 Lecom Pl Erie PA 16505-2571 | |
| (814) 868-2524 | |
| (814) 868-2522 |
| Full Name | State Street Primary Care |
|---|---|
| Speciality | Family Medicine |
| Location | 1 Lecom Pl, Erie, Pennsylvania |
| Authorized Official Name and Position | Dennis M Styn (PRESIDENT) |
| Authorized Official Contact | 8148682504 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| State Street Primary Care 1 Lecom Pl Erie PA 16505-2571 Ph: (814) 868-2524 | State Street Primary Care 1 Lecom Pl Erie PA 16505-2571 Ph: (814) 868-2524 |
| NPI Number | 1285981407 |
|---|---|
| Provider Enumeration Date | 08/07/2012 |
| Last Update Date | 12/18/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285981407 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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