LIBERTY STREET INTERNAL MEDICINE PC (NPI# 1952618696) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952618696 |
| Entity Type | Organization |
| Organization Name | LIBERTY STREET INTERNAL MEDICINE PC |
| Practice Address |
765 Liberty St Suite 301 Meadville PA 16335-2566 |
| Practice Telephone | 8143331081 |
| Practice Fax Number | 8147248343 |
| Mailing Telephone | 8143363506 |
| Mailing Fax Number | 8147248343 |
| Enumeration Date | 2010-09-01 |
| Last Update Date | 2010-09-03 |
| Authorized Official Name | MRS. CYNTHIA A YEAGER (ADMINISTRATIVE ASSISTANT) |
| Authorized Official Telephone | 8143363506 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | MD440871 | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | LICENSE | MD440871 | 01 |
| Street Address |
765 LIBERTY ST SUITE 301 |
| City | MEADVILLE |
| State | PA |
| Zip Code | 16335-2566 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578566113 | Sharon Palotas | Nurse Practitioner | 765 Liberty St, Suite 309, Meadville, PA 16335-2566 | 2005-05-27 |
| 1124408604 | Meadville Physician Services | Internal Medicine | 765 Liberty St, Ste 309, Meadville, PA 16335-2566 | 2015-06-01 |
| 1225432545 | Emily Prenatt | Physician Assistant | 765 Liberty St, Meadville, PA 16335-2566 | 2014-10-15 |
| 1962804955 | French Creek Internal Medicine | Internal Medicine | 765 Liberty St, 307, Meadville, PA 16335-2566 | 2014-09-22 |
| 1801296470 | Oyler Internal Medicine, LLC | Internal Medicine | 765 Liberty St, Suite 307, Meadville, PA 16335-2566 | 2014-09-02 |
| 1255773784 | Dipesh Maan | Internal Medicine | 765 Liberty St, Meadville, PA 16335-2566 | 2013-07-25 |
| 1093154924 | Meadville Physician Services | Family Medicine | 765 Liberty St, Suite 310, Meadville, PA 16335-2566 | 2013-06-25 |
| 1831534189 | Anthony Randolph | Internal Medicine | 765 Liberty St, Suite 307, Meadville, PA 16335-2566 | 2013-04-30 |
| 1538420658 | Meadville Medical Center | Psychiatry & Neurology | 765 Liberty St, Suite 303, Meadville, PA 16335-2566 | 2012-06-05 |
| 1114287414 | Meadville Physician Services | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 765 Liberty St, Suite 105, Meadville, PA 16335-2566 | 2012-05-21 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811533508 | Stacey Lynette Lantz | Physical Therapy Assistant | 11277 Vernon Place Road, Meadville, PA 16335 | 2019-11-18 |
| 1952874794 | Amy Lynn Weaver | Social Worker | Parkside Psychological Associates, 435 Chestnut Street, Meadville, PA 16335 | 2019-01-04 |
| 1013437789 | Raymond Walter Keller Jr. | Family Medicine | 735 Liberty St, Meadville, PA 16335 | 2017-06-23 |
| 1750735742 | Nicole Fies | Counselor | 201 Chestnut Street, Floor 2, Meadville, PA 16335 | 2016-04-16 |
| 1760894422 | Amie S Coffman | Psychiatry & Neurology | 765 Liberty St Ste 303, Meadville, PA 16335 | 2014-05-28 |
| 1649609710 | Gina Marie Michalak | Pharmacist | 379 North Street, Meadville, PA 16335 | 2013-11-08 |
| 1518396704 | Cassandra Lynn Ketler | Physician Assistant | 847 North Main Street, Meadville, PA 16335 | 2013-11-07 |
| 1194159913 | Judy Mcelwain | Speech-Language Pathologist | 31 N Park Ave, Meadville, PA 16335 | 2013-08-28 |
| 1649604463 | Jonelle Elizabeth Taylor | Occupational Therapist | 31 North Park Ave, Meadville, PA 16335 | 2013-08-28 |
| 1699046961 | James Richard Mclamb | Orthopaedic Surgery | 6060 Ehrgott Rd, Meadville, PA 16335 | 2012-01-19 |
| Find all providers in zip 16335 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154397693 | Charlotte Bowen Wagamon | Internal Medicine | 15957 Conneaut Lake Road Suite 3, Meadville, PA 16335 | 2006-02-24 |
| 1922008820 | Douglas Alan Fronzaglia II | Internal Medicine | 600 Wesley Way, Meadville, PA 16335-9413 | 2005-07-21 |
| 1124408604 | Meadville Physician Services | Internal Medicine | 765 Liberty St, Ste 309, Meadville, PA 16335-2566 | 2015-06-01 |
| 1801296470 | Oyler Internal Medicine, LLC | Internal Medicine | 765 Liberty St, Suite 307, Meadville, PA 16335-2566 | 2014-09-02 |
| 1831534189 | Anthony Randolph | Internal Medicine | 765 Liberty St, Suite 307, Meadville, PA 16335-2566 | 2013-04-30 |
| 1891041893 | Gurleen Pasricha | Internal Medicine | 16792 Conneaut Lake Rd, Meadville, PA 16335-3748 | 2012-07-27 |
| 1124301064 | Meadville Medical Associates LLC | Internal Medicine | 765 Liberty Street, Suite 309, Meadville, PA 16335-2566 | 2011-09-27 |
| 1528244456 | Lisa Marie Raiber | Internal Medicine | 1034 Grove St, Meadville, PA 16335-2945 | 2008-01-10 |
| 1447336540 | Medi-surg of Meadville Inc | Internal Medicine | 765 Liberty St, Suite # 301, Meadville, PA 16335-2566 | 2006-10-31 |
| 1316021751 | Charles Patrick Cole | Internal Medicine | 1012 Water St, Meadville, PA 16335 | 2006-10-24 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.