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General NPI Number Information
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NPI Number | 1851417315
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Entity Type | Organization
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Legal Business Name | JOHN C. LYCHAK, M.D.,P.C.
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 35 E ELIZABETH AVE STE 21
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City | BETHLEHEM
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State | PA
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Zip | 18018-6505
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Country | US
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Telephone | 610-865-5775
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Fax | 610-865-3955
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Provider Business Mailing Address
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Address Line | 35 E ELIZABETH AVE STE 21
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City | BETHLEHEM
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State | PA
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Zip | 18018-6505
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Country | US
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Telephone | 610-865-5775
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Fax | 610-865-3955
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN CHARLES LYCHAK
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Credential | M.D.
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Telephone | 610-865-5775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD023301L
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License Number State | PA
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