Organization
GENESIS VASCULAR OF LEHIGH VALLEY, LLC
Active
Parent organization
GENESIS GLOBAL HEALTHCARE
Other names
GV of Lehigh Valley
Organization subpart
Yes
Provider details
NPI number
Legal business name
GENESIS GLOBAL HEALTHCARE
Authorized official
JAMES THOMAS O'DARE III (PRINCIPAL)
(215) 630-4909
Entity
Organization
Contact information
Practice address
2111 WASHINGTON BLVD STE 1, EASTON, PA 18042-3803
(484) 544-4160
(484) 544-4188
Mailing address
575 N ROUTE 73 STE A6, WEST BERLIN, NJ 08091-2440
(856) 335-5025
(856) 213-9269
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
—
—
207RI0011X
Interventional Cardiology Physician
Primary
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
2086S0129X
Vascular Surgery Physician
—
—
Other
Enumeration date
05/18/2015
Last updated
05/18/2015
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