Healthcare Provider Details

I. General information

NPI: 1447714977
Provider Name (Legal Business Name): RAMA ESKANDER PAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2019
Last Update Date: 01/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 CETRONIA RD STE 205N
ALLENTOWN PA
18104-9263
US

IV. Provider business mailing address

240 CETRONIA RD STE 205N
ALLENTOWN PA
18104-9263
US

V. Phone/Fax

Practice location:
  • Phone: 484-426-2600
  • Fax: 833-816-7512
Mailing address:
  • Phone: 484-426-2600
  • Fax: 833-816-7512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA060444
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: