Provider Demographics
NPI:1689031015
Name:UROLOGY SPECIALISTS OF THE LEHIGH VALLEY, PC
Entity Type:Organization
Organization Name:UROLOGY SPECIALISTS OF THE LEHIGH VALLEY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.O.O.
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:FENSTERMAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-223-4165
Mailing Address - Street 1:5018 MEDICAL CENTER CIR
Mailing Address - Street 2:SUITE 101B
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18106-9661
Mailing Address - Country:US
Mailing Address - Phone:484-876-5649
Mailing Address - Fax:610-432-6562
Practice Address - Street 1:5018 MEDICAL CENTER CIR
Practice Address - Street 2:SUITE 101B
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18106-9661
Practice Address - Country:US
Practice Address - Phone:484-876-5649
Practice Address - Fax:610-432-6562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-15
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site