MEDICARE: GYNECOLOGIC ONCOLOGY ASSOCIATES OF LEHIGH VALLEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VX0201X	Gynecologic Oncology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427016302
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GYNECOLOGIC ONCOLOGY ASSOCIATES OF LEHIGH VALLEY

Provider Business Mailing Address
First Line	:	1611 POND ROAD
Second Line	:	SUITE 101 LEHIGH VALLEY WOMENS CANCER CENTER
City	:	ALLENTOWN
State	:	PA
Zip	:	18104-2258
Country	:	US
Telephone Number	:	610-366-8555
Fax Number	:	610-366-8550

Provider Business Practice Location Address
First Line	:	1611 POND ROAD
Second Line	:	SUITE 101 LEHIGH VALLEY WOMENS CANCER CENTER
City	:	ALLENTOWN
State	:	PA
Zip	:	18104-2258
Country	:	US
Telephone Number	:	610-366-8555
Fax Number	:	610-366-8550

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	MR. GAZI ABDULHAY
Credential	:	MD
Telephone Number	:	610-366-8555

Provider Enumeration Date	:	05/02/2006
Last Update Date	:	08/14/2007

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