Provider Demographics
NPI:1093706996
Name:GRIESER, RHONDA K (PA)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:K
Last Name:GRIESER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:RHONDA
Other - Middle Name:K
Other - Last Name:DELP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:1259 S CEDAR CREST BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-6373
Mailing Address - Country:US
Mailing Address - Phone:610-437-4134
Mailing Address - Fax:610-433-9690
Practice Address - Street 1:1259 S CEDAR CREST BLVD STE 100
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6373
Practice Address - Country:US
Practice Address - Phone:610-437-4134
Practice Address - Fax:610-433-9690
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA000544L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
P26580Medicare UPIN
P26580Medicare UPIN
PA217894Medicare PIN
PA232359401OtherMLHC TIN