Healthcare Provider Details

I. General information

NPI: 1538063318
Provider Name (Legal Business Name): LEHIGH VALLEY SPECIALTY PHYSICIAN GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1230 S CEDAR CREST BLVD STE 301
ALLENTOWN PA
18103-6212
US

IV. Provider business mailing address

2100 MACK BLVD FL 4
ALLENTOWN PA
18103-5622
US

V. Phone/Fax

Practice location:
  • Phone: 610-432-4529
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: JENNIFER STEPHENS
Title or Position: CMO
Credential:
Phone: 484-862-3152