Provider Demographics
NPI:1851417315
Name:JOHN C. LYCHAK, M.D.,P.C.
Entity Type:Organization
Organization Name:JOHN C. LYCHAK, M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:LYCHAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-865-5775
Mailing Address - Street 1:35 E ELIZABETH AVE STE 21
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-6505
Mailing Address - Country:US
Mailing Address - Phone:610-865-5775
Mailing Address - Fax:610-865-3955
Practice Address - Street 1:35 E ELIZABETH AVE STE 21
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-6505
Practice Address - Country:US
Practice Address - Phone:610-865-5775
Practice Address - Fax:610-865-3955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD023301L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA03104600OtherLEGACY ID
PA011243Medicare ID - Type Unspecified
PA03104600OtherLEGACY ID