Healthcare Provider Details

I. General information

NPI: 1790315554
Provider Name (Legal Business Name): LVHN COORDINATED PROFESSIONAL PRACTICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2020
Last Update Date: 02/15/2020
Certification Date: 02/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2775 SCHOENERSVILLE RD
BETHLEHEM PA
18017-7307
US

IV. Provider business mailing address

2775 SCHOENERSVILLE RD
BETHLEHEM PA
18017-7307
US

V. Phone/Fax

Practice location:
  • Phone: 610-861-8080
  • Fax:
Mailing address:
  • Phone: 610-861-8080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: THOMAS MARCHOZZI
Title or Position: SR VP & CFO
Credential:
Phone: 484-862-3943