Basic Information
Provider Information | |||||||||
NPI: | 1245289867 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | LAHAV | ||||||||
FirstName: | ERIKA | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | MD | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 1650 VALLEY CENTER PKWY | ||||||||
Address2: | SUITE 100 | ||||||||
City: | BETHLEHEM | ||||||||
State: | PA | ||||||||
PostalCode: | 180172344 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 4848844436 | ||||||||
FaxNumber: | 4848844444 | ||||||||
Practice Location | |||||||||
Address1: | 2045 WESTGATE DR | ||||||||
Address2: | SUITE 305 | ||||||||
City: | BETHLEHEM | ||||||||
State: | PA | ||||||||
PostalCode: | 180177480 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6108670832 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 05/09/2006 | ||||||||
LastUpdateDate: | 04/21/2014 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | Y | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD040108L | PA | Y |   | Allopathic & Osteopathic Physicians | Internal Medicine |   |
ID Information
ID | Type | State | Issuer | Description | 20031285 | 01 | PA | AMERIHEALTH HMO | OTHER | 01004701 | 01 | PA | CAPITAL BLUE CROSS | OTHER | 0794922000 | 01 | PA | PERSONAL CHOICE | OTHER | 110216155 | 01 | PA | RAILROAD MEDICARE | OTHER | P2584944 | 01 | PA | OXFORD HEALTH PLAN | OTHER | 0010878020006 | 05 | PA |   | MEDICAID | 0563507 | 01 | PA | AETNA HMO | OTHER | 1528621 | 01 | PA | GATEWAY HEALTH PLAN | OTHER | 806635 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER |