Provider Demographics
NPI:1215978119
Name:LEHIGH VALLEY PEDIATRIC ASSOCIATES INC
Entity type:Organization
Organization Name:LEHIGH VALLEY PEDIATRIC ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-434-2162
Mailing Address - Street 1:1251 S CEDAR CREST BLVD STE 109
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-6205
Mailing Address - Country:US
Mailing Address - Phone:610-434-2162
Mailing Address - Fax:610-434-9370
Practice Address - Street 1:1251 S CEDAR CREST BLVD STE 109
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6205
Practice Address - Country:US
Practice Address - Phone:610-434-2162
Practice Address - Fax:610-434-9370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007161340001Medicaid
PAS002306L006OtherHIGHMARK WHOLECARE
PA063329OtherHIGHMARK BLUE SHIELD
PAS002306L007OtherHIGHMARK WHOLECARE
PA02346100OtherCAPITAL BLUE CROSS
PA18012OtherAETNA