Basic Information
| Provider Information | |||||||||
| NPI: | 1902129679 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NEPHROLOGY-HYPERTENSION ASSOCIATES OF LEHIGH VALLEY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2014 CITY LINE RD | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | BETHLEHEM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180172159 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6102645199 | ||||||||
| FaxNumber: | 6102645198 | ||||||||
| Practice Location | |||||||||
| Address1: | 2014 CITY LINE RD | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | BETHLEHEM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180172159 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6102645199 | ||||||||
| FaxNumber: | 6102645198 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/09/2010 | ||||||||
| LastUpdateDate: | 03/16/2010 | ||||||||
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| AuthorizedOfficialLastName: | HARRISON | ||||||||
| AuthorizedOfficialFirstName: | DREW | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 6102583608 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA1903X | 22041501 | PA | Y | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |
No ID Information.