Healthcare Provider Details

I. General information

NPI: 1265966444
Provider Name (Legal Business Name): CHILDREN'S SURGERY CENTER OF LEHIGH VALLEY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2017
Last Update Date: 04/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

89 S COMMERCE WAY SUITE 900
BETHLEHEM PA
18017-8952
US

IV. Provider business mailing address

596 LANCASTER AVE SUITE 100
MALVERN PA
19355-1808
US

V. Phone/Fax

Practice location:
  • Phone: 609-977-4466
  • Fax:
Mailing address:
  • Phone: 609-977-4466
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: GINA ESPENSCHIED
Title or Position: COO
Credential:
Phone: 609-977-4466