Organization
FAMILY DERMATOLOGY OF THE LEHIGH VALLEY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN JEAN KUCIRKA MD (OWNER)
(610) 769-4200
Entity
Organization
Contact information
Practice address
4110 INDEPENDENCE DR, STE 300, SCHNECKSVILLE, PA 18078
(610) 769-4200
(610) 769-4204
Mailing address
4110 INDEPENDENCE DR, STE 300, SCHNECKSVILLE, PA 18078
(610) 769-4200
(610) 769-4204
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD031979E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1580638
BLUE SHIELD
PA
01
—
50029439
BLUE CROSS
PA
Enumeration date
02/07/2006
Last updated
03/18/2013
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