Eric J Lake is a Sports Medicine in Havertown, Pennsylvania. Eric J Lake practices all healthcare services and medical treatments related to Sports Medicine. The NPI Number for Eric J Lake is 1710919139. The last update date is 2012-07-18.
Eric J Lake's current location address is 525 W Chester Pike, Havertown, Pennsylvania. You can contact this provider via phone number 6107897767 and fax number 6107897768. The mailing address for Eric J Lake is 525 W Chester Pike, Havertown, Pennsylvania. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Eric J Lake |
|---|---|
| Address | 525 W Chester Pike, Havertown, Pennsylvania |
| Phone Number | 6107897767 |
| Fax Number | 6107897768 |
| Sole Proprietor | N |
| Credentials | DO |
NPI Number Detail
| NPI Number | 1710919139 |
|---|---|
| Provider Enumeration Date | 2006-07-07 |
| Last Updated Date | 2012-07-18 |
Provider Mailing Address Detail
| Address | 525 W Chester Pike |
|---|---|
| City | Havertown |
| State | Pennsylvania (PA) |
| Post Code | 190834500 |
| Phone Number | 6107897767 |
| Fax Number | 6107897768 |
Provider's Primary Taxonomy Detail
| Speciality | Sports Medicine |
|---|---|
| Taxonomy | 207Qs0010X |
| Licence No | OS012275 |
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Definition: A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1016353100001 | PA | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Eric J Lake by the Centers for Medicare & Medicaid Services?
The Eric J Lake has been assigned the NPI (National Provider Identifier) 1710919139 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you please provide the complete street address where Eric J Lake is physically located?
The Eric J Lake is physically situated at the following address: 525 W Chester Pike, Havertown, PA, 190834500.
What is the Eric J Lake's area of specialization and corresponding taxonomy classification?
The Eric J Lake's specialty field is Sports Medicine, and it falls under the taxonomy code 207Qs0010X, which categorizes healthcare providers based on their specialties.
When did Eric J Lake receive its 1710919139 assignment?
The Eric J Lake was assigned its 1710919139 on 2006-07-07, which is the date when this unique identifier was issued to the organization.
When was the Eric J Lake's information last updated?
The Eric J Lake's information was last updated on 2012-07-18.