Organization
ALC OF LEHIGH VALLEY INC
Active
Other names
Azani Medical Spa
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MONICA CECILIA GAVIN MD (CEO/MEDICAL DIRECTOR)
(610) 530-0151
Entity
Organization
Contact information
Practice address
3101 EMRICK BLVD, SUITE #201, BETHLEHEM, PA 18020-8037
(610) 625-3000
(610) 625-3003
Mailing address
3067 JORDAN RD, OREFIELD, PA 18069-2261
(610) 625-3000
(610) 625-3003
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
MD061743L
PA
Other
Enumeration date
07/23/2006
Last updated
05/29/2010
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