=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760424188
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DRS S SHAH D GIANGIULIO B AHMED
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/11/2006
-----------------------------------------------------
Last Update Date | 04/02/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1240 S CEDAR CREST BLVD SUITE 305
-----------------------------------------------------
City | ALLENTOWN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18103-6218
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-821-2700
-----------------------------------------------------
Fax | 610-821-5431
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1240 S CEDAR CREST BLVD SUITE 305
-----------------------------------------------------
City | ALLENTOWN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18103-6218
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-821-2700
-----------------------------------------------------
Fax | 610-821-5431
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | GENERAL PARTNER
-----------------------------------------------------
Name | DR. DENNIS J GIANGIULIO
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 610-821-2700
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------