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General NPI Number Information
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NPI Number | 1801499850
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Entity Type | Organization
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Legal Business Name | AVICENNA PHYSICIAN SERVICES INC
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Dates
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Enumeration Date | 11/20/2020
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 5148 HAMILTON BLVD
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City | ALLENTOWN
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State | PA
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Zip | 18106-9788
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Country | US
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Telephone | 610-904-8100
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Fax | 610-638-0753
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Provider Business Mailing Address
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Address Line | 5148 HAMILTON BLVD
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City | ALLENTOWN
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State | PA
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Zip | 18106-9788
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Country | US
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Telephone | 610-904-8100
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Fax | 610-638-0753
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Authorized Official
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Title or Position | CEO
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Name | BILAL ARSHAD MANNAN
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Credential | MD
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Telephone | 347-645-8517
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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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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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