Healthcare Provider Details

I. General information

NPI: 1780748152
Provider Name (Legal Business Name): LEHIGH VALLEY HOSPITAL HAZLETON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 E BROAD ST
HAZLETON PA
18201-6835
US

IV. Provider business mailing address

700 E BROAD ST
HAZLETON PA
18201-6835
US

V. Phone/Fax

Practice location:
  • Phone: 570-501-4000
  • Fax:
Mailing address:
  • Phone: 570-501-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number083701
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: ROBERT THOMAS
Title or Position: CHIEF ACCOUNTING OFFICER
Credential:
Phone: 484-884-0901