Organization
BANGOR PODIATRY LLC
Active
Organization
BANGOR PODIATRY LLC
Active
Other names
Bangor Podiatry of Bethlehem
Organization subpart
No
Provider details
NPI number
Authorized official
CHERALYN PERKINS (OFFICE MANAGER)
(610) 588-6621
Entity
Organization
Contact information
Practice address
224 NAZARETH PIKE, BETHLEHEM, PA 18020-9080
(610) 351-9244
(610) 351-9247
Mailing address
325 BLUE VALLEY DR, BANGOR, PA 18013-1526
(610) 588-6621
(610) 588-6307
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
—
PA
332B00000X
Durable Medical Equipment & Medical Supplies
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1025694980001
—
PA
Enumeration date
04/25/2016
Last updated
03/26/2024
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