Organization
PROGRESSIVE PHYSICIAN ASSOC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSANNE DEANGELO (ADMINISTRATION/CREDENTIALING)
(610) 868-1100
Entity
Organization
Contact information
Practice address
1021 PARK AVE, QUAKERTOWN, PA 18951-1573
(610) 868-1100
(610) 868-1111
Mailing address
PO BOX 1156, BETHLEHEM, PA 18016-1156
(610) 868-1100
(610) 868-1111
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
—
—
2085N0904X
Nuclear Radiology Physician
—
PA
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
2086S0129X
Vascular Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1303700-0023
—
PA
Enumeration date
05/01/2008
Last updated
12/02/2013
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