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General NPI Number Information
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NPI Number | 1699871178
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Entity Type | Individual
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Provider Name | STEPHEN A DULE PAC
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Gender | Male
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 01/13/2022
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Provider Practice Location Address
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Address Line | 390 PIERCE ST
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City | KINGSTON
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State | PA
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Zip | 18704-5532
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Country | US
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Telephone | 570-288-3535
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Fax | 570-288-0804
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Provider Business Mailing Address
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Address Line | 2775 SCHOENERSVILLE RD
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City | BETHLEHEM
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State | PA
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Zip | 18017-7307
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Country | US
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Telephone | 610-861-8080
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Fax | 610-861-0854
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | MA002491L
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License Number State | PA
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