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General NPI Number Information
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NPI Number | 1952394918
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Entity Type | Organization
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Legal Business Name | EMAUS AVENUE FAMILY PRACTICE
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Dates
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Enumeration Date | 08/25/2005
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Last Update Date | 06/15/2010
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Provider Practice Location Address
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Address Line | 1101 W EMAUS AVE
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City | ALLENTOWN
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State | PA
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Zip | 18103-6676
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Country | US
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Telephone | 610-797-2000
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Fax | 610-791-5814
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Provider Business Mailing Address
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Address Line | 1101 W EMAUS AVE
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City | ALLENTOWN
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State | PA
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Zip | 18103-6676
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Country | US
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Telephone | 610-797-2000
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Fax | 610-791-5814
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Authorized Official
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Title or Position | PHYSICIAN PARTNER
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Name | DR. RUTH E FRYE
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Credential | D.O.
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Telephone | 610-797-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | QW15076
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License Number State | PA
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