Healthcare Provider Details

I. General information

NPI: 1063588549
Provider Name (Legal Business Name): LEHIGH VALLEY PAIN & PRIMARY CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 09/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1146 S. CEDAR CREST BLVD 2ND FLOOR
ALLENTOWN PA
18103-7938
US

IV. Provider business mailing address

1146 S. CEDAR CREST BLVD 2ND FLOOR
ALLENTOWN PA
18103-7938
US

V. Phone/Fax

Practice location:
  • Phone: 610-366-9000
  • Fax: 610-366-9229
Mailing address:
  • Phone: 610-366-9000
  • Fax: 610-366-9229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: YASIN KHAN
Title or Position: OWNER
Credential:
Phone: 610-366-9000