Provider Demographics
NPI:1659433357
Name:ALLENTOWN MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:ALLENTOWN MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COOWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:PELLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-758-1100
Mailing Address - Street 1:163 BURLINGTON PATH RD
Mailing Address - Street 2:CREAM RIDGE PROFESSIONAL CENTER UNIT L
Mailing Address - City:CREAM RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08514-1622
Mailing Address - Country:US
Mailing Address - Phone:609-758-1100
Mailing Address - Fax:609-758-3188
Practice Address - Street 1:163 BURLINGTON PATH RD
Practice Address - Street 2:CREAM RIDGE PROFESSIONAL CENTER UNIT L
Practice Address - City:CREAM RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08514-1622
Practice Address - Country:US
Practice Address - Phone:609-758-1100
Practice Address - Fax:609-758-3188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-16
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA47072207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty