MEDICARE: DR. KARENTON MORDI DNP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	26NJ00835100	NJ
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	SP030271	PA

General Provider Information

NPI Number	:	1831675636
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KARENTON MORDI DNP

Provider Business Mailing Address
First Line	:	182 BETHLEHEM PIKE
Second Line	:
City	:	COLMAR
State	:	PA
Zip	:	18915-9790
Country	:	US
Telephone Number	:	215-997-2000
Fax Number	:	215-997-2282

Provider Business Practice Location Address
First Line	:	1246 W TILGHMAN STREET
Second Line	:
City	:	ALLENTOWN
State	:	PA
Zip	:	18102-2136
Country	:	US
Telephone Number	:	484-221-8296
Fax Number	:	484-221-8318

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2018
Last Update Date	:	05/26/2026

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