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General NPI Number Information
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NPI Number | 1831314038
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Entity Type | Organization
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Legal Business Name | EDWARD J. LUNDEEN, PH.D.
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Dates
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Enumeration Date | 04/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2245 WALBERT AVE
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City | ALLENTOWN
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State | PA
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Zip | 18104-1358
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Country | US
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Telephone | 610-820-8499
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Fax | 810-820-0311
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Provider Business Mailing Address
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Address Line | 2245 WALBERT AVE
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City | ALLENTOWN
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State | PA
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Zip | 18104-1358
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Country | US
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Telephone | 610-820-8499
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Fax | 810-820-0311
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Authorized Official
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Title or Position | OWNER
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Name | DR. EDWARD JOHN LUNDEEN
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Credential | PH.D.
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Telephone | 610-820-8499
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PA006798L
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License Number State | PA
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