1215978119 NPI number — LEHIGH VALLEY PEDIATRIC ASSOCIATES INC

Table of content: (NPI 1215978119)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215978119 NPI number — LEHIGH VALLEY PEDIATRIC ASSOCIATES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LEHIGH VALLEY PEDIATRIC ASSOCIATES INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215978119
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/20/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1251 S CEDAR CREST BLVD STE 109
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALLENTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18103-6205
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-434-2162
Provider Business Mailing Address Fax Number:
610-434-9370

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1251 S CEDAR CREST BLVD STE 109
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18103-6205
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-434-2162
Provider Business Practice Location Address Fax Number:
610-434-9370
Provider Enumeration Date:
06/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WILLIAMS
Authorized Official First Name:
CATHY
Authorized Official Middle Name:
Authorized Official Title or Position:
PRACTICE ADMINISTRATOR
Authorized Official Telephone Number:
610-434-2162

Provider Taxonomy Codes

  • Taxonomy code: 208000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0007161340001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: S002306L006 . This is a "HIGHMARK WHOLECARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 063329 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: S002306L007 . This is a "HIGHMARK WHOLECARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 02346100 . This is a "CAPITAL BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 18012 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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