Provider Demographics
NPI:1063588549
Name:LEHIGH VALLEY PAIN & PRIMARY CARE INC.
Entity type:Organization
Organization Name:LEHIGH VALLEY PAIN & PRIMARY CARE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YASIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-366-9000
Mailing Address - Street 1:1146 S. CEDAR CREST BLVD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-7938
Mailing Address - Country:US
Mailing Address - Phone:610-366-9000
Mailing Address - Fax:610-366-9229
Practice Address - Street 1:1146 S. CEDAR CREST BLVD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-7938
Practice Address - Country:US
Practice Address - Phone:610-366-9000
Practice Address - Fax:610-366-9229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA141005Medicare ID - Type Unspecified