Provider Demographics
NPI:1528163938
Name:ALLENTOWN ASSOCIATES IN PSYCHIATRY AND PSYCHOLOGY
Entity type:Organization
Organization Name:ALLENTOWN ASSOCIATES IN PSYCHIATRY AND PSYCHOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:K
Authorized Official - Last Name:GROSS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-820-3900
Mailing Address - Street 1:1245 SOUTH CEDAR CREST BLVD.
Mailing Address - Street 2:SUITE 303
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103
Mailing Address - Country:US
Mailing Address - Phone:610-820-3900
Mailing Address - Fax:610-820-8647
Practice Address - Street 1:1245 SOUTH CEDAR CREST BLVD.
Practice Address - Street 2:SUITE 303
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103
Practice Address - Country:US
Practice Address - Phone:610-820-3900
Practice Address - Fax:610-820-8647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018813750005Medicaid
PA511482OtherHIGHMARK BLUE SHIELD
PA02345500OtherCAPITAL BLUE CROSS
PA0005529530001Medicaid