Healthcare Provider Details

I. General information

NPI: 1831500842
Provider Name (Legal Business Name): LINDSEY KUDENCHAK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LINDSEY ROBEL MD

II. Dates (important events)

Enumeration Date: 05/13/2014
Last Update Date: 09/16/2021
Certification Date: 09/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 S CEDAR CREST BLVD
ALLENTOWN PA
18103-6202
US

IV. Provider business mailing address

813 CRESSMAN RD
HARLEYSVILLE PA
19438-2606
US

V. Phone/Fax

Practice location:
  • Phone: 610-402-6700
  • Fax: 610-402-6744
Mailing address:
  • Phone: 201-400-5695
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MA09720500
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD460697
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD460697
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: