1417910340 NPI number — WILLIAM J. LIEN, M.D., P.C.

Table of content: (NPI 1417910340)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417910340 NPI number — WILLIAM J. LIEN, M.D., P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WILLIAM J. LIEN, M.D., P.C.
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:
BOYERTOWN FAMILY MEDICINE
Provider Other Organization Name Type Code:
3
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:
1417910340
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/27/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9 ROWELL RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BOYERTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19512-8933
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-369-0900
Provider Business Mailing Address Fax Number:
610-473-0333

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9 ROWELL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BOYERTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19512-8933
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-369-0900
Provider Business Practice Location Address Fax Number:
610-473-0333
Provider Enumeration Date:
04/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LIEN
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
JAMES
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
610-369-0900

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 118224 . This is a "AMERIHEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7083165 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 02334400 . This is a "CAPITAL BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: DB2853 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0918224 . This is a "HIGHMARK BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0860382001 . This is a "INDEPENDENCE BLUE CROSS" identifier . This identifiers is of the category "OTHER".




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