Basic Information
| Provider Information | |||||||||
| NPI: | 1851345813 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NORTHERN LEHIGH PRIMARY CARE | ||||||||
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| 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: | 586 MOORESTOWN DR | ||||||||
| Address2: | |||||||||
| City: | BATH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180149713 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6107462010 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/22/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | ERICKSON | ||||||||
| AuthorizedOfficialFirstName: | JANET | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6107462010 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | PA | X | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | 207R00000X | PA | X | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1633684 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 2309493001 | 01 | PA | KEYSTONE EAST | OTHER | 2309493001 | 01 | PA | AMERIHEALTH HMO | OTHER | DC1875 | 01 | PA | RAILROAD MEDICARE | OTHER | 3665820 | 01 | PA | AETNA HMO | OTHER | 50039229 | 01 | PA | CAPITAL | OTHER | 3000354 | 01 | PA | KEYSTONE CENTRAL | OTHER | P3403941 | 01 | PA | OXFORD | OTHER | 1633684 | 01 | PA | PERSONAL CHOICE | OTHER | 7557625 | 01 | PA | AETNA | OTHER | E1D6 | 01 | PA | GEISINGER | OTHER |