Provider Demographics
NPI:1427038785
Name:LENART, WILLIAM T (OD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:T
Last Name:LENART
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 W 18TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16501-2103
Mailing Address - Country:US
Mailing Address - Phone:814-454-7138
Mailing Address - Fax:814-459-6332
Practice Address - Street 1:147 W 18TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16501-2103
Practice Address - Country:US
Practice Address - Phone:814-454-7138
Practice Address - Fax:814-459-6332
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001057152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010539940001Medicaid
PAU08110Medicare UPIN
PALE403609Medicare ID - Type Unspecified