Provider Demographics
NPI:1790253904
Name:LEHIGH VALLEY PHYSICIAN GROUP
Entity Type:Organization
Organization Name:LEHIGH VALLEY PHYSICIAN GROUP
Other - Org Name:LVPG -MATLV DAVID P. ZAMBO, DO
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGER INSURANCE ENROLLMENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:FOEHRKOLB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-884-0720
Mailing Address - Street 1:1605 N CEDAR CREST BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-2351
Mailing Address - Country:US
Mailing Address - Phone:610-973-1400
Mailing Address - Fax:610-973-1450
Practice Address - Street 1:4263 LONAT DRIVE
Practice Address - Street 2:
Practice Address - City:NAZARETH
Practice Address - State:PA
Practice Address - Zip Code:18064-8403
Practice Address - Country:US
Practice Address - Phone:610-572-2296
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LEHIGH VALLEY PHYSICIAN GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-11-06
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty