Organization
ALLENTOWN ANESTHESIA ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA ANN BOTY (PRACTICE ADMINISTRATOR)
(484) 866-9583
Entity
Organization
Contact information
Practice address
4905 W. TILGHMAN ST, SUITE 250, ALLENTOWN, PA 18104
(484) 866-9583
(610) 366-1147
Mailing address
4905 W. TILGHMAN ST, SUITE 250, ALLENTOWN, PA 18104
(484) 866-9583
(610) 366-1147
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
PA
363A00000X
Physician Assistant
—
PA
363L00000X
Nurse Practitioner
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007166800008
—
PA
01
—
0040553000
INDEP. BLUE CROSS
PA
01
—
066511
HIGHMARK
PA
05
—
3527409
—
NJ
01
—
46933
KEYSTONE MERCY
PA
01
—
7066511
GATEWAY
PA
01
—
AL6651
KEYSTONE CENTRAL
PA
01
—
P003209
TRICARE
PA
Enumeration date
10/06/2005
Last updated
05/10/2017
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