Healthcare Provider Details

I. General information

NPI: 1487960639
Provider Name (Legal Business Name): SPECIALTY PHYSICIAN ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2010
Last Update Date: 02/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3445 HIGH POINT BLVD., SUITE 400
BETHLEHEM PA
18017-7817
US

IV. Provider business mailing address

3445 HIGH POINT BLVD. SUITE 400
BETHLEHEM PA
18017-7817
US

V. Phone/Fax

Practice location:
  • Phone: 610-866-5555
  • Fax: 610-866-3151
Mailing address:
  • Phone: 610-866-5555
  • Fax: 610-866-3151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207YX0602X
TaxonomyOtolaryngic Allergy Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID M YEN
Title or Position: OWNER/PRESIDENT
Credential: M.D.
Phone: 610-866-5555