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General NPI Number Information
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NPI Number | 1053452755
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Entity Type | Individual
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Provider Name | RON MAHLAB M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 210 N 6TH ST
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City | ALLENTOWN
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State | PA
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Zip | 18102-4112
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Country | US
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Telephone | 610-432-4356
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Fax | 484-221-9130
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Provider Business Mailing Address
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Address Line | PO BOX 5349
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City | BETHLEHEM
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State | PA
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Zip | 18015-0349
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Country | US
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Telephone | 484-221-9136
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Fax | 484-221-9130
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD065683L
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License Number State | PA
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