Basic Information
| Provider Information | |||||||||
| NPI: | 1710973920 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FELEGY | ||||||||
| FirstName: | TANIA | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | PAC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1501 LEHIGH ST | ||||||||
| Address2: | 103 | ||||||||
| City: | ALLENTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 181033880 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6106288410 | ||||||||
| FaxNumber: | 6106288434 | ||||||||
| Practice Location | |||||||||
| Address1: | 1501 LEHIGH ST | ||||||||
| Address2: | 103 | ||||||||
| City: | ALLENTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 181033880 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6106288410 | ||||||||
| FaxNumber: | 6106288434 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/22/2005 | ||||||||
| LastUpdateDate: | 01/30/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | MA001626L | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
ID Information
| ID | Type | State | Issuer | Description | 50047098 | 01 | CBC | OTHER | 20014948 | 01 | AMERIHEALTH MERCY | OTHER |