Provider Demographics
NPI:1427016302
Name:GYNECOLOGIC ONCOLOGY ASSOCIATES OF LEHIGH VALLEY
Entity Type:Organization
Organization Name:GYNECOLOGIC ONCOLOGY ASSOCIATES OF LEHIGH VALLEY
Other - Org Name:LEHIGH VALLEY WOMENS CANCER CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GAZI
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDULHAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-366-8555
Mailing Address - Street 1:1611 POND ROAD
Mailing Address - Street 2:SUITE 101 LEHIGH VALLEY WOMENS CANCER CENTER
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 ROAD
Practice Address - Street 2:SUITE 101 LEHIGH VALLEY WOMENS CANCER CENTER
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:2006-05-02
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1422480Medicaid
PA1422480Medicaid