Healthcare Provider Details
I. General information
NPI: 1134285653
Provider Name (Legal Business Name): LEHIGH VALLEY PHYSICIAN GROUP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/29/2006
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3080 HAMILTON BLVD STE 200
ALLENTOWN PA
18103-3692
US
IV. Provider business mailing address
PO BOX 783311
PHILADELPHIA PA
19178-3311
US
V. Phone/Fax
- Phone: 484-661-4641
- Fax: 484-661-4844
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0205X |
| Taxonomy | Pediatric Endocrinology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JENNIFER
STEPHENS
Title or Position: SR VP & CHIEF VALUE OFFICER
Credential:
Phone: 484-884-4500