# LEHIGH VALLEY PHYSICIAN GROUP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bognet Medical Associates, PC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912525247
- **Authorized official:** BREANNA SANTIAGO (PROVIDER ENROLLMENT LIAISON)
- **Authorized official phone:** (484) 884-0661

## Contact information

- **Practice address:** 1275 S CEDAR CREST BLVD STE 5, ALLENTOWN, PA 18103-6207
- **Practice address phone:** (610) 821-2820
- **Practice address fax:** (610) 821-2859
- **Mailing address:** 1605 N CEDAR CREST BLVD STE 110B, ALLENTOWN, PA 18104-2351
- **Mailing address phone:** (610) 973-1410
- **Mailing address fax:** (610) 973-1449

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/13/2020
- **Last updated:** 07/13/2020