Healthcare Provider Details

I. General information

NPI: 1275594830
Provider Name (Legal Business Name): NORTHEASTERN ANESTHESIA PHYSICIANS P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 12/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1736 W HAMILTON ST
ALLENTOWN PA
18104-5656
US

IV. Provider business mailing address

24 S 18TH ST
ALLENTOWN PA
18104-5622
US

V. Phone/Fax

Practice location:
  • Phone: 610-628-8372
  • Fax: 610-628-8648
Mailing address:
  • Phone: 610-628-8372
  • Fax: 610-628-8648

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: BRADLEY S PARLIN
Title or Position: CHIEF OF ANESTHESIA
Credential: DO
Phone: 610-628-8372