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951 N 4th St Allentown PA 18102-1852 | |
(610) 434-8801 | |
(610) 433-0205 |
Full Name | |
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Speciality | Family Medicine |
Location | 951 N 4th St, 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 | 951 N 4th St Allentown PA 18102-1852 Ph: (610) 434-8801 |
NPI Number | 1053373548 |
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Provider Enumeration Date | 04/03/2006 |
Last Update Date | 02/25/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1053373548 | NPI | - | NPPES |
100184 | Other | AMERIHEALTH MERCY HEALTH | |
404651 | Other | PA | HIGHMARK BS GROUP NUMBER |
03160900 | Other | PA | CBC GROUP NUMBER |
4450492 | Other | AETNA PPO | |
0006504 | Other | AETNA HMO | |
0041064001 | Other | IBC | |
1519301 | Other | GATEWAY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |