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1210 Hanover Ave Allentown PA 18109-2017 | |
(610) 437-6490 | |
(610) 437-4151 |
Full Name | |
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Speciality | Family Medicine |
Location | 1210 Hanover Ave, Allentown, Pennsylvania |
Authorized Official Name and Position | Stephen A Lanshe (VP LEGAL AFFAIRS) |
Authorized Official Contact | 6107765141 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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421 W Chew St Physician Accounts Allentown PA 18102-3406 Ph: (610) 776-5100 | 1210 Hanover Ave Allentown PA 18109-2017 Ph: (610) 437-6490 |
NPI Number | 1326008228 |
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Provider Enumeration Date | 03/24/2006 |
Last Update Date | 02/25/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1326008228 | NPI | - | NPPES |
1519695 | Other | GATEWAY ASSURED | |
564229 | Other | PA | HIGHMARK BLS GROUP # |
0006472 | Other | AETNA HMO | |
0218423001 | Other | IBC | |
02400200 | Other | PA | CBC GROUP # |
5844495 | Other | AETNA PPO | |
47661 | Other | AMERIHEALTH MERCY HEALTH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |