MEDICARE: MRS. ELIZABETH ANNE YARDLEY MD

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	207Q00000X	Family Medicine Physician	LL32794	SC
2	207Q00000X	Family Medicine Physician	62583	WI
3	207Q00000X	Family Medicine Physician	MD474812	PA

General Provider Information

NPI Number	:	1528370806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELIZABETH ANNE YARDLEY MD

Provider Business Mailing Address
First Line	:	2100 MACK BLVD
Second Line	:
City	:	ALLENTOWN
State	:	PA
Zip	:	18103-5622
Country	:	US
Telephone Number	:	484-884-0617
Fax Number	:	484-884-0628

Provider Business Practice Location Address
First Line	:	2401 NORTHAMPTON ST STE 130
Second Line	:
City	:	EASTON
State	:	PA
Zip	:	18045-2764
Country	:	US
Telephone Number	:	484-591-7420
Fax Number	:	484-591-7421

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/02/2010
Last Update Date	:	03/09/2022

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