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General NPI Number Information
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NPI Number | 1396570180
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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 | 09/03/2024
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Last Update Date | 09/03/2024
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Provider Practice Location Address
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Address Line | 420 W 23RD ST
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City | HAZLE TOWNSHIP
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State | PA
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Zip | 18202-1302
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Country | US
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Telephone | 570-455-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 1605 N CEDAR CREST BLVD STE 110B
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City | ALLENTOWN
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State | PA
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Zip | 18104-2351
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SVP
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Name | JAMES DEMOPOULOS
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Credential |
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Telephone | 484-862-3333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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