Provider Demographics
NPI:1386738326
Name:LEHIGH VALLEY CARDIO DIAGNOSTICS PC
Entity type:Organization
Organization Name:LEHIGH VALLEY CARDIO DIAGNOSTICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:PANTANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-770-2200
Mailing Address - Street 1:PO BOX 3667
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18106-0667
Mailing Address - Country:US
Mailing Address - Phone:610-289-2980
Mailing Address - Fax:610-289-2990
Practice Address - Street 1:1251 S CEDAR CREST BLVD
Practice Address - Street 2:SUITE 201A
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103
Practice Address - Country:US
Practice Address - Phone:610-289-2980
Practice Address - Fax:610-289-2990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010094680011Medicaid
PA0010094680011Medicaid