Healthcare Provider Details

I. General information

NPI: 1740272434
Provider Name (Legal Business Name): PAUL F POLLICE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2005
Last Update Date: 11/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 CETRONIA ROAD SUITE 303
ALLENTOWN PA
18104-9168
US

IV. Provider business mailing address

250 CETRONIA RD STE 303
ALLENTOWN PA
18104-9168
US

V. Phone/Fax

Practice location:
  • Phone: 610-973-6200
  • Fax: 610-973-6546
Mailing address:
  • Phone: 610-973-6200
  • Fax: 866-644-0894

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD070458L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License NumberMD070458L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: