Organization
CREST RADIOLOGICAL ASSOCIATES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HENRY MICHAEL FRIESS MD (PRESIDENT)
(610) 776-5325
Entity
Organization
Contact information
Practice address
421 W CHEW ST, DEPARTMENT OF DIAGNOSTIC RADIOLOGY, ALLENTOWN, PA 18102-3406
(610) 776-4822
(610) 776-4671
Mailing address
421 W CHEW ST, PHYSICIAN ACCOUNTS, ALLENTOWN, PA 18102-3406
(610) 776-5100
(610) 663-3113
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006736180002
—
PA
01
—
0040604000
IBC
—
01
—
02410000
CBC
—
01
—
068337
HIGHMARK BLUE SHIELD GROU
—
01
—
1519574
GATEWAY HEALTH PLAN
—
01
—
46716
AMERIHEALTH MERCY
—
01
—
CI1114
RR MEDICARE GROUP #
—
Enumeration date
11/14/2005
Last updated
10/19/2007
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