Healthcare Provider Details
I. General information
NPI: 1255153581
Provider Name (Legal Business Name): CDC BETHLEHEM, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/28/2024
Last Update Date: 10/28/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3933 FREEMANSBURG AVE
BETHLEHEM PA
18020-4567
US
IV. Provider business mailing address
1445 W BROAD ST
QUAKERTOWN PA
18951-1109
US
V. Phone/Fax
- Phone: 215-538-2500
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207N00000X |
| Taxonomy | Dermatology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DAVID
TWARDZIK
Title or Position: OWNER
Credential: MD
Phone: 215-538-2500