Provider Demographics
NPI:1891713608
Name:LOCKMAN-LUBELL PEDIATRIC ASSOCIATES, LLC
Entity Type:Organization
Organization Name:LOCKMAN-LUBELL PEDIATRIC ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LIEBERHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-646-6868
Mailing Address - Street 1:270 COMMERCE DR
Mailing Address - Street 2:SUITE 250
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19034-2405
Mailing Address - Country:US
Mailing Address - Phone:215-653-0600
Mailing Address - Fax:215-646-4422
Practice Address - Street 1:270 COMMERCE DR
Practice Address - Street 2:SUITE 250
Practice Address - City:FORT WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:19034-2405
Practice Address - Country:US
Practice Address - Phone:215-653-0600
Practice Address - Fax:215-646-4422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01900550Medicaid