Provider Demographics
NPI:1720189244
Name:LAKE ERIE WOMENS CENTER
Entity Type:Organization
Organization Name:LAKE ERIE WOMENS CENTER
Other - Org Name:LAKESIDE OB/GYN
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MD OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:G
Authorized Official - Last Name:LEVINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-873-3926
Mailing Address - Street 1:215 HOLLAND ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16507
Mailing Address - Country:US
Mailing Address - Phone:814-453-5058
Mailing Address - Fax:814-452-4174
Practice Address - Street 1:215 HOLLAND ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16507
Practice Address - Country:US
Practice Address - Phone:814-453-5058
Practice Address - Fax:814-452-4174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty