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General NPI Number Information
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NPI Number | 1104195684
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Entity Type | Organization
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Legal Business Name | LEHIGH VALLEY PHYSICIAN GROUP
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Dates
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Enumeration Date | 12/29/2011
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Last Update Date | 08/14/2015
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Provider Practice Location Address
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Address Line | 1240 S CEDAR CREST BLVD SUITE 208
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City | ALLENTOWN
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State | PA
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Zip | 18103-6369
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Country | US
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Telephone | 610-402-9780
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 783311
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City | PHILADELPHIA
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State | PA
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Zip | 19178-3311
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Country | US
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Telephone | 484-884-4500
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Fax |
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Authorized Official
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Title or Position | VP, CFO
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Name | JOHN BERZINSKY
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Credential |
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Telephone | 484-884-4500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State | PA
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