1851345813 NPI number — NORTHERN LEHIGH PRIMARY CARE

Table of content: (NPI 1851345813)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851345813 NPI number — NORTHERN LEHIGH PRIMARY CARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTHERN LEHIGH PRIMARY CARE
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:
1851345813
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1650 VALLEY CENTER PKWY
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
BETHLEHEM
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18017-2344
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
484-884-4436
Provider Business Mailing Address Fax Number:
484-884-4444

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
586 MOORESTOWN DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BATH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18014-9713
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-746-2010
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ERICKSON
Authorized Official First Name:
JANET
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
610-746-2010

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 207R00000X , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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

  • Identifier: 1633684 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2309493001 . This is a "KEYSTONE EAST" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2309493001 . This is a "AMERIHEALTH HMO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: DC1875 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 3665820 . This is a "AETNA HMO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 50039229 . This is a "CAPITAL" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 3000354 . This is a "KEYSTONE CENTRAL" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: P3403941 . This is a "OXFORD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1633684 . This is a "PERSONAL CHOICE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 7557625 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: E1D6 . This is a "GEISINGER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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