MEDICARE: NEPHROLOGY-HYPERTENSION 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	261QA1903X	Ambulatory Surgical Clinic/Center	22041501	PA

General Provider Information

NPI Number	:	1902129679
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEPHROLOGY-HYPERTENSION ASSOCIATES OF LEHIGH VALLEY

Provider Business Mailing Address
First Line	:	2014 CITY LINE RD
Second Line	:	SUITE 101
City	:	BETHLEHEM
State	:	PA
Zip	:	18017-2159
Country	:	US
Telephone Number	:	610-264-5199
Fax Number	:	610-264-5198

Provider Business Practice Location Address
First Line	:	2014 CITY LINE RD
Second Line	:	SUITE 101
City	:	BETHLEHEM
State	:	PA
Zip	:	18017-2159
Country	:	US
Telephone Number	:	610-264-5199
Fax Number	:	610-264-5198

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DREW HARRISON
Credential	:	MD
Telephone Number	:	610-258-3608

Provider Enumeration Date	:	03/09/2010
Last Update Date	:	03/16/2010

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