1851340483 NPI number — BETHLEHEM PULMONARY ASSOC

Table of content: TEAH LISA LYNN HIGGINS (NPI 1285384214)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851340483 NPI number — BETHLEHEM PULMONARY ASSOC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BETHLEHEM PULMONARY ASSOC
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:
1851340483
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/16/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1901 W HAMILTON ST
Provider Second Line Business Mailing Address:
SUITE 100B
Provider Business Mailing Address City Name:
ALLENTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18104-6459
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-973-1410
Provider Business Mailing Address Fax Number:
610-973-1449

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5325 NORTHGATE DR
Provider Second Line Business Practice Location Address:
SUITE 209
Provider Business Practice Location Address City Name:
BETHLEHEM
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18017-9411
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-866-2048
Provider Business Practice Location Address Fax Number:
610-866-5058
Provider Enumeration Date:
05/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ZASIK
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
M
Authorized Official Title or Position:
DOCTOR
Authorized Official Telephone Number:
610-866-2048

Provider Taxonomy Codes

  • Taxonomy code: 207RP1001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 02359000 . This is a "CAPITAL BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0012335170004 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 641967 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: CL4515 . This is a "PALMETTO GBA" identifier . This identifiers is of the category "OTHER".




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