# LEHIGH VALLEY PHYSICIAN GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942609599
- **Authorized official:** MICHAEL ROSSI (VP/CFO)
- **Authorized official phone:** (484) 884-4500

## Contact information

- **Practice address:** 564 W BROAD ST, SUITE 2, HAZLETON, PA 18201-6108
- **Practice address phone:** (570) 501-6220
- **Practice address fax:** (570) 501-2795
- **Mailing address:** PO BOX 783311, PHILADELPHIA, PA 19178-3311
- **Mailing address phone:** (484) 884-4500
- **Mailing address fax:** (484) 884-0699

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/20/2014
- **Last updated:** 07/18/2017