Provider Demographics
NPI:1477523793
Name:LENNERT, JOSEPH B (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:B
Last Name:LENNERT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5325 NORTHGATE DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-9411
Mailing Address - Country:US
Mailing Address - Phone:610-867-3171
Mailing Address - Fax:610-867-1941
Practice Address - Street 1:5325 NORTHGATE DR
Practice Address - Street 2:SUITE 203
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-9411
Practice Address - Country:US
Practice Address - Phone:610-867-3171
Practice Address - Fax:610-867-1941
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-26
Last Update Date:2010-07-01
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Provider Licenses
StateLicense IDTaxonomies
PAMD015306E208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000756603Medicaid
PAB35553Medicare UPIN
PA000756603Medicaid