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124 E Susquehanna St Allentown PA 18103-5138 | |
(610) 797-1600 | |
(610) 797-1355 |
Full Name | |
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Speciality | Family Medicine |
Location | 124 E Susquehanna 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 | 124 E Susquehanna St Allentown PA 18103-5138 Ph: (610) 797-1600 |
NPI Number | 1326000647 |
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Provider Enumeration Date | 04/03/2006 |
Last Update Date | 02/25/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1326000647 | NPI | - | NPPES |
1680744 | Other | PA | HIGHMARK BLS GROUP NUMBER |
2356859001 | Other | IBC | |
7661623 | Other | AETNA PPO | |
50047883 | Other | PA | CBC GROUP NUMBER |
20043807 | Other | AMERIHEALTH MERCY HEALTH | |
1545714 | Other | GATEWAY HEALTH PLAN | |
3810828 | Other | AETNA HMO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |