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NPI Code Detail

MEDICARE: GASTROENTEROLOGY ASSOCIATES LTD

MEDICARE: GASTROENTEROLOGY ASSOCIATES LTD
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
1207RG0100XGastroenterology Physician

Other Identifiers

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

General Provider Information

NPI Number : 1518959360
Entity Type Code : Organization
Provider Name (Legal Business Name) : GASTROENTEROLOGY ASSOCIATES LTD
Provider Business Mailing Address
First Line : 3131 COLLEGE HEIGHTS BLVD
Second Line :
City : ALLENTOWN
State : PA
Zip : 18104-4812
Country : US
Telephone Number : 610-439-8551
Fax Number : 610-439-1435
Provider Business Practice Location Address
First Line : 3131 COLLEGE HEIGHTS BLVD
Second Line :
City : ALLENTOWN
State : PA
Zip : 18104-4812
Country : US
Telephone Number : 610-439-8551
Fax Number : 610-439-1435
Authorized Official
Title or Position : PRESIDENT
Name : JACOB HARRY PICKLE IV
Credential : MD
Telephone Number : 610-439-8551
Provider Enumeration Date : 08/18/2005
Last Update Date : 09/20/2018

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ALLENTOWN, PA
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1215939327 — SUZANNE DIXON AMANT PA- C
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1104828128 — ROSANNE MARIE DAY PAC
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1174525117 — JACOB HARRY PICKLE IV MD
Practice Location Address:
3131 COLLEGE HEIGHTS BLVD , SUITE 1200
ALLENTOWN, PA
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1841282241 — SEAN ROBERT LACEY MD
Practice Location Address:
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Practice Fax: 610-439-1435

Directions to “GASTROENTEROLOGY ASSOCIATES LTD ” Practice Location

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