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Organization
LEHIGH VALLEY PHYSICIAN GROUP
Active
Organization
LEHIGH VALLEY PHYSICIAN GROUP
Active
Parent organization
LEHIGH VALLEY PHYSICIAN GROUP
Other names
FAIRMONT MEDICAL CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
LEHIGH VALLEY PHYSICIAN GROUP
Authorized official
BREANNA SANTIAGO (PROVIDER ENROLLMENT LIAISON)
(484) 884-0661
Entity
Organization
Contact information
Practice address
1720 W FAIRMONT ST, ALLENTOWN, PA 18104-3118
(610) 841-2798
(610) 841-2796
Mailing address
1605 N CEDAR CREST BLVD STE 110B, ALLENTOWN, PA 18104-2351
(610) 973-1410
(610) 973-1449
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
05/02/2019
Last updated
05/02/2019
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