Provider Demographics
NPI:1558313106
Name:SPEED, LEE E (PA)
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:E
Last Name:SPEED
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:PO BOX 1754
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18105-1754
Mailing Address - Country:US
Mailing Address - Phone:610-798-4500
Mailing Address - Fax:610-798-4699
Practice Address - Street 1:1250 S CEDAR CREST BLVD
Practice Address - Street 2:SUITE 310
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6224
Practice Address - Country:US
Practice Address - Phone:610-402-6890
Practice Address - Fax:610-402-6892
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2010-02-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMA002431L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0993510OtherKEYSTONE CENTRAL
PA20045751OtherAMERIHEALTH MERCY
PAP00186451OtherRAILROAD MEDICARE
PA500443524OtherCAPITAL BLUE CROSS
PA500443524OtherCAPITAL BLUE CROSS
PA0993510OtherKEYSTONE CENTRAL