Provider Demographics
NPI:1598476939
Name:ERGINA, PATRICK LEE
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:LEE
Last Name:ERGINA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 BELVEDERE ROAD
Mailing Address - Street 2:
Mailing Address - City:WESTMOUNT
Mailing Address - State:QUEBEC
Mailing Address - Zip Code:H3Y1P4
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1001 DECARIE BOULEVARD
Practice Address - Street 2:C7.1284
Practice Address - City:MONTREAL
Practice Address - State:QUEBEC
Practice Address - Zip Code:H4A3J1
Practice Address - Country:CA
Practice Address - Phone:514-843-1463
Practice Address - Fax:514-843-1602
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-06
Last Update Date:2022-12-14
Deactivation Date:2022-12-07
Deactivation Code:
Reactivation Date:2022-12-14
Provider Licenses
StateLicense IDTaxonomies
HIMD5367208G00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine