Healthcare Provider Details
I. General information
NPI: 1922172782
Provider Name (Legal Business Name): LEHIGH VALLEY PHYSICIAN GROUP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/20/2006
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2545 SCHOENERSVILLE RD
BETHLEHEM PA
18017-7300
US
IV. Provider business mailing address
PO BOX 783311
PHILADELPHIA PA
19178-3311
US
V. Phone/Fax
- Phone: 484-884-3333
- Fax: 484-884-3366
- Phone: 484-884-4500
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0207X |
| Taxonomy | Pediatric Hematology & Oncology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JENNIFER
STEPHENS
Title or Position: SR VP & CHIEF VALUE OFFICER
Credential:
Phone: 484-884-4500