Provider Demographics
NPI:1932159688
Name:SPECIALTY PHYSICIANS OF LVHN PC
Entity type:Organization
Organization Name:SPECIALTY PHYSICIANS OF LVHN PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:SZYDLOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-402-6896
Mailing Address - Street 1:1650 VALLEY CENTER PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-2344
Mailing Address - Country:US
Mailing Address - Phone:484-884-4436
Mailing Address - Fax:484-884-4444
Practice Address - Street 1:1240 S CEDAR CREST BLVD
Practice Address - Street 2:SUITE 403
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6218
Practice Address - Country:US
Practice Address - Phone:610-402-6896
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA20034829OtherAMERIHEALTH MERCY
PA1537881OtherGATEWAY HEALTH PLAN
PA1012982100001Medicaid
PA2319685000OtherAMERIHEALTH (IBC)
PADC1976OtherRAILROAD MEDICARE
PA3000303OtherKEYSTONE CENTRAL
PA50039527OtherCAPITAL BLUE CROSS
PA50039527OtherCAPITAL BLUE CROSS