Provider Demographics
NPI:1619923901
Name:LEHIGH VALLEY HOSPITAL
Entity Type:Organization
Organization Name:LEHIGH VALLEY HOSPITAL
Other - Org Name:MHMR CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KAUFMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-402-1155
Mailing Address - Street 1:1650 VALLEY CENTER PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-2344
Mailing Address - Country:US
Mailing Address - Phone:484-884-4436
Mailing Address - Fax:484-884-4444
Practice Address - Street 1:17TH & CHEW STREETS
Practice Address - Street 2:3RD FLOOR
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104
Practice Address - Country:US
Practice Address - Phone:610-402-1155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1041C0700X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1368494OtherBLUE SHIELD
PA1368494OtherBLUE SHIELD