Healthcare Provider Details

I. General information

NPI: 1194118216
Provider Name (Legal Business Name): LYSSLEX, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2015
Last Update Date: 03/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1251 S CEDAR CREST BLVD SUITE 209
ALLENTOWN PA
18103-6205
US

IV. Provider business mailing address

1251 S CEDAR CREST BLVD SUITE 209
ALLENTOWN PA
18103-6205
US

V. Phone/Fax

Practice location:
  • Phone: 610-770-2036
  • Fax: 610-770-2039
Mailing address:
  • Phone: 610-770-2036
  • Fax: 610-770-2039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number24753601
License Number StatePA

VIII. Authorized Official

Name: PAMELA T BARTLETT
Title or Position: OWNER
Credential:
Phone: 610-770-2036