Healthcare Provider Details
I. General information
NPI: 1518913813
Provider Name (Legal Business Name): MUHLENBERG HOSPITAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/26/2006
Last Update Date: 09/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2545 SCHOENERSVILLE RD BANKO BUILDING
BETHLEHEM PA
18017-7300
US
IV. Provider business mailing address
1650 VALLEY CENTER PKWY SUITE 100
BETHLEHEM PA
18017-2344
US
V. Phone/Fax
- Phone: 610-866-9000
- Fax:
- Phone: 484-884-4436
- Fax: 484-884-4444
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 364S00000X |
| Taxonomy | Clinical Nurse Specialist |
| License Number | |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103G00000X |
| Taxonomy | Clinical Neuropsychologist |
| License Number | |
| License Number State | PA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | PA |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | PA |
VIII. Authorized Official
Name:
MICHAEL
KAUFMANN
Title or Position: PRESIDENT
Credential: MD
Phone: 610-866-9000