Basic Information
| Provider Information | |||||||||
| NPI: | 1851340483 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BETHLEHEM PULMONARY ASSOC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1901 W HAMILTON ST | ||||||||
| Address2: | SUITE 100B | ||||||||
| City: | ALLENTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 181046459 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6109731410 | ||||||||
| FaxNumber: | 6109731449 | ||||||||
| Practice Location | |||||||||
| Address1: | 5325 NORTHGATE DR | ||||||||
| Address2: | SUITE 209 | ||||||||
| City: | BETHLEHEM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180179411 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6108662048 | ||||||||
| FaxNumber: | 6108665058 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/10/2006 | ||||||||
| LastUpdateDate: | 10/16/2007 | ||||||||
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| AuthorizedOfficialLastName: | ZASIK | ||||||||
| AuthorizedOfficialFirstName: | JOSEPH | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | DOCTOR | ||||||||
| AuthorizedOfficialTelephone: | 6108662048 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
ID Information
| ID | Type | State | Issuer | Description | 02359000 | 01 | PA | CAPITAL BLUE CROSS | OTHER | 0012335170004 | 05 | PA | MEDICAID | 641967 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | CL4515 | 01 | PALMETTO GBA | OTHER |