Provider Demographics
NPI:1043576374
Name:NEXTGEN ENDOSCOPY CENTRE LLC
Entity Type:Organization
Organization Name:NEXTGEN ENDOSCOPY CENTRE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:KLECKNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-366-8555
Mailing Address - Street 1:1611 POND RD
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-2258
Mailing Address - Country:US
Mailing Address - Phone:610-366-8555
Mailing Address - Fax:610-366-8550
Practice Address - Street 1:1611 POND RD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-2258
Practice Address - Country:US
Practice Address - Phone:610-366-8555
Practice Address - Fax:610-366-8550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0800XAmbulatory Health Care FacilitiesClinic/CenterEndoscopy