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General NPI Number Information
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NPI Number | 1942641865
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Entity Type | Organization
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Legal Business Name | GYNECOLOGIC ONCOLOGY OF LEHIGH VALLEY, LLC
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Dates
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Enumeration Date | 07/08/2013
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Last Update Date | 07/08/2013
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Provider Practice Location Address
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Address Line | 1611 POND RD STE 101
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City | ALLENTOWN
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State | PA
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Zip | 18104-2258
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Country | US
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Telephone | 610-366-8555
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Fax | 610-366-8550
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Provider Business Mailing Address
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Address Line | 1611 POND RD STE 101
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City | ALLENTOWN
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State | PA
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Zip | 18104-2258
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Country | US
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Telephone | 610-366-8555
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Fax | 610-366-8550
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GAZI ABDULHAY
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Credential | M.D.
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Telephone | 610-366-8555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VX0201X
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Taxonomy Name | Gynecologic Oncology Physician
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License Number | MD-040489-E
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License Number State | PA
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