Provider Demographics
NPI:1538165493
Name:LESSESKI, DAVID C (DO)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:C
Last Name:LESSESKI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 W 23RD ST STE 202
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16502-2858
Mailing Address - Country:US
Mailing Address - Phone:814-452-5081
Mailing Address - Fax:814-452-7918
Practice Address - Street 1:145 W 23RD ST STE 202
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16502-2858
Practice Address - Country:US
Practice Address - Phone:814-452-5081
Practice Address - Fax:814-452-7918
Is Sole Proprietor?:No
Enumeration Date:2005-06-24
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS007417L207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015254040002Medicaid
PA0015254040002Medicaid
PAE95859Medicare UPIN