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General NPI Number Information
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NPI Number | 1235126046
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Entity Type | Organization
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Legal Business Name | LEHIGH VALLEY GROUP PC
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Dates
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Enumeration Date | 10/06/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 250 S 21ST ST
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City | EASTON
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State | PA
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Zip | 18042-3851
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Country | US
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Telephone | 610-250-4474
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Fax | 610-250-4899
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Provider Business Mailing Address
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Address Line | 2501 OREGON PIKE SUITE 101
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City | LANCASTER
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State | PA
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Zip | 17601-4890
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Country | US
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Telephone | 717-390-2467
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Fax | 717-560-0879
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PREM K MARLAPUDI
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Credential | M.D.
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Telephone | 610-250-4474
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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