MEDICARE: GASTROENTEROLOGY ASSOCIATES OF PENN MEDICAL GROUP, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician

General Provider Information

NPI Number	:	1225139066
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GASTROENTEROLOGY ASSOCIATES OF PENN MEDICAL GROUP, P.C.

Provider Business Mailing Address
First Line	:	1901 W HAMILTON ST
Second Line	:	SUITE 100B
City	:	ALLENTOWN
State	:	PA
Zip	:	18104-6459
Country	:	US
Telephone Number	:	610-973-1400
Fax Number	:	610-973-1449

Provider Business Practice Location Address
First Line	:	400 S 9TH ST
Second Line	:
City	:	LEHIGHTON
State	:	PA
Zip	:	18235-1812
Country	:	US
Telephone Number	:	610-379-0443
Fax Number	:	610-379-0587

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	CHERYL SENSINGER
Credential	:
Telephone Number	:	610-379-0443

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	08/22/2020

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