1013963479 NPI number — MEDICAL ASSOCIATES OF THE LEHIGH VALLEY PC

Table of content: MS. KENDRA ALEXANDRA SCOTT REGISTERED NURSE (NPI 1407679053)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013963479 NPI number — MEDICAL ASSOCIATES OF THE LEHIGH VALLEY PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEDICAL ASSOCIATES OF THE LEHIGH VALLEY PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013963479
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/02/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1605 N CEDAR CREST BLVD
Provider Second Line Business Mailing Address:
SUITE110B
Provider Business Mailing Address City Name:
ALLENTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18104-2351
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-973-1400
Provider Business Mailing Address Fax Number:
610-973-1449

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3201 HIGHFIELD DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BETHLEHEM
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18020-1113
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-868-0775
Provider Business Practice Location Address Fax Number:
610-954-5538
Provider Enumeration Date:
05/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
STOVER
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
E
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
610-973-1400

Provider Taxonomy Codes

  • Taxonomy code: 208000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 02300300 . This is a "CAPITAL BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 836102 . This is a "HIGHMARK PA BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: CA1229 . This is a "PALMETTO RR" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com