Organization
PAIN SPECIALISTS OF GREATER LEHIGH VALLEY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORETTA KOWALICK (PRACTICE ADMINISTRATOR)
(610) 402-1757
Entity
Organization
Contact information
Practice address
1240 S CEDAR CREST BLVD, SUITE #307, ALLENTOWN, PA 18103-6369
(610) 402-1757
(610) 402-9089
Mailing address
1245 S CEDAR CREST BLVD, SUITE #301, ALLENTOWN, PA 18103-6258
(610) 402-1757
(610) 402-9089
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
—
PA
261QP3300X
Pain Clinic/Center
—
PA
363L00000X
Nurse Practitioner
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018828370001
—
PA
01
—
02009185000
IBC
PA
01
—
03158300
CAPITAL BLUE CROSS
PA
01
—
1316068
HIGHMARK
PA
01
—
1522741
GATEWAY
PA
01
—
20012177
AMERIHEALTH MERCY
PW
01
—
2608852
AETNA
PA
01
—
30000050
KEYSTONE MERCY
PA
Enumeration date
10/06/2005
Last updated
07/21/2022
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