Provider Demographics
NPI:1568536324
Name:LVPG VASCULAR HEALTH SERVICES
Entity Type:Organization
Organization Name:LVPG VASCULAR HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOC EXECUTIVE DRIECTOR FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:KNOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-798-4500
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:
Practice Address - Street 1:1627 W CHEW ST
Practice Address - Street 2:#403
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18102-3648
Practice Address - Country:US
Practice Address - Phone:610-969-4727
Practice Address - Fax:610-969-4078
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LEHIGH VALLEY PHYSICIAN GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-20
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty