Provider Demographics
NPI:1821237215
Name:ERIC LAGER, M.D., P.C.
Entity Type:Organization
Organization Name:ERIC LAGER, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:LAGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-665-1867
Mailing Address - Street 1:2400 CHESTNUT ST
Mailing Address - Street 2:3302
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-4316
Mailing Address - Country:US
Mailing Address - Phone:215-665-1867
Mailing Address - Fax:
Practice Address - Street 1:2400 CHESTNUT ST
Practice Address - Street 2:3302
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-4316
Practice Address - Country:US
Practice Address - Phone:215-665-1867
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-09
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA006433E261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA015308Medicare PIN