Provider Demographics
NPI:1467502054
Name:ORTHOPAEDIC ASSOCIATES OF ALLENTOWN
Entity Type:Organization
Organization Name:ORTHOPAEDIC ASSOCIATES OF ALLENTOWN
Other - Org Name:OAA DIAGNOSTIC IMAGING CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-973-6480
Mailing Address - Street 1:250 CETRONIA ROAD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104
Mailing Address - Country:US
Mailing Address - Phone:610-973-6500
Mailing Address - Fax:
Practice Address - Street 1:250 CETRONIA ROAD
Practice Address - Street 2:SUITE 101
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104
Practice Address - Country:US
Practice Address - Phone:610-973-6500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50060632OtherCAPTIAL BLUE CROSS
PA50060632OtherCAPTIAL BLUE CROSS