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NPI Code Detail

MEDICARE: SHALEY CHAROUS

MEDICARE: SHALEY CHAROUS
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1881398097
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHALEY CHAROUS
Provider Business Mailing Address
First Line : 1200 S CEDAR CREST BLVD BLDG 2ND
Second Line :
City : ALLENTOWN
State : PA
Zip : 18103-6202
Country : US
Telephone Number : 610-402-1374
Fax Number : 610-402-4230
Provider Business Practice Location Address
First Line : 1200 S CEDAR CREST BLVD
Second Line :
City : ALLENTOWN
State : PA
Zip : 18103-6202
Country : US
Telephone Number : 484-862-3156
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2023
Last Update Date : 05/26/2026

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Directions to “ SHALEY CHAROUS ” Practice Location

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