Healthcare Provider Details

I. General information

NPI: 1558808287
Provider Name (Legal Business Name): VALLEY KIDNEY SPECIALISTS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2017
Last Update Date: 08/24/2022
Certification Date: 08/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2014 CITY LINE RD SUITE 101
BETHLEHEM PA
18017
US

IV. Provider business mailing address

1230 S CEDAR CREST BLVD SUITE 301
ALLENTOWN PA
18103-6367
US

V. Phone/Fax

Practice location:
  • Phone: 610-264-5199
  • Fax: 610-264-5198
Mailing address:
  • Phone: 610-432-4529
  • Fax: 610-432-2206

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ERIC J FELS
Title or Position: MEDICAL DIRECTOR
Credential: DO
Phone: 610-264-5199