Healthcare Provider's Profile
| Full Name | |
|---|
| Type | Facility |
|---|
| Speciality | Special Hospital |
|---|
| Location | 1503 N Cedar Crest Blvd, Allentown, Pennsylvania |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1043456957
- Provider Enumeration Date: 12/23/2008
- Last Update Date: 01/23/2020
Medical Identifiers
Medical identifiers for
such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1043456957 | NPI | - | NPPES |
| 50087524 | Other | | CAPITAL BLUE CROSS |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 111N00000X | Chiropractor | (Pennsylvania) | Secondary |
| 207KA0200X | Allergy & Immunology - Allergy | (Pennsylvania) | Secondary |
| 207L00000X | Anesthesiology | (Pennsylvania) | Secondary |
| 207RR0500X | Internal Medicine - Rheumatology | (Pennsylvania) | Secondary |
| 207X00000X | Orthopaedic Surgery | (Pennsylvania) | Secondary |
| 207XS0106X | Orthopaedic Surgery - Hand Surgery | (Pennsylvania) | Secondary |
| 207XS0117X | Orthopaedic Surgery - Orthopaedic Surgery Of The Spine | (Pennsylvania) | Secondary |
| 208100000X | Physical Medicine & Rehabilitation | (Pennsylvania) | Secondary |
| 208200000X | Plastic Surgery | (Pennsylvania) | Secondary |
| 2082S0105X | Plastic Surgery - Surgery Of The Hand | (Pennsylvania) | Secondary |
| 2085R0202X | Radiology - Diagnostic Radiology | (Pennsylvania) | Secondary |
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | (Pennsylvania) | Secondary |
| 225100000X | Physical Therapist | (Pennsylvania) | Secondary |
| 225X00000X | Occupational Therapist | (Pennsylvania) | Secondary |
| 284300000X | Special Hospital | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
1503 N Cedar Crest Blvd,
Allentown, PA 18104-2310
Ph: (610) 861-8080 |
1503 N Cedar Crest Blvd,
Allentown, PA 18104-2310
Ph: (610) 861-8080 |
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