1811390909 NPI number — BETH A FOLIO MD

Table of content: (NPI 1295061539)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811390909 NPI number — BETH A FOLIO MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FOLIO
Provider First Name:
BETH
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FOLIO
Provider Other First Name:
BETH
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1811390909
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/18/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 783311
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19178-3311
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
484-884-4500
Provider Business Mailing Address Fax Number:
484-884-0699

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1611 POND RD
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-398-7700
Provider Business Practice Location Address Fax Number:
610-398-6917
Provider Enumeration Date:
10/02/2014

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  MD040347L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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