Basic Information
Provider Information
NPI: 1730131541
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PASSMAN
FirstName: HARVEY
MiddleName: B
NamePrefix: DR.
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1605 N CEDAR CREST BLVD
Address2: SUITE 110B
City: ALLENTOWN
State: PA
PostalCode: 181042351
CountryCode: US
TelephoneNumber: 6109731410
FaxNumber: 6109731449
Practice Location
Address1: 4520 PARK VIEW DR
Address2:  
City: SCHNECKSVILLE
State: PA
PostalCode: 180782552
CountryCode: US
TelephoneNumber: 6107994241
FaxNumber: 4844034008
Other Information
ProviderEnumerationDate: 05/17/2006
LastUpdateDate: 08/15/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XOS003698LPAY Allopathic & Osteopathic PhysiciansFamily Medicine 

ID Information
IDTypeStateIssuerDescription
0107440201PACAPITAL BLUE CROSSOTHER
13654101PAHIGHMARK PA BLUE SHIELDOTHER
08005372001PAPALMETTO GBA MEDICAREOTHER


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