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3570 Hamilton Blvd Suite 201 Allentown PA 18103-4541 | |
(610) 433-7481 | |
(610) 433-3991 |
Full Name | |
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Speciality | Family Medicine |
Location | 3570 Hamilton Blvd, 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 | 3570 Hamilton Blvd Suite 201 Allentown PA 18103-4541 Ph: (610) 433-7481 |
NPI Number | 1023079886 |
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Provider Enumeration Date | 03/31/2006 |
Last Update Date | 02/25/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023079886 | NPI | - | NPPES |
1519302 | Other | GATEWAY HEALTH PLAN | |
0125575 | Other | AETNA HMO | |
5265574 | Other | AETNA PPO | |
03162800 | Other | PA | CBC GROUP NUMBER |
334203 | Other | PA | HIGHMARK BLS GROUP NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |