Provider Demographics
NPI:1902835788
Name:LEHIGH VALLEY CENTER FOR SIGHT PC
Entity Type:Organization
Organization Name:LEHIGH VALLEY CENTER FOR SIGHT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DIETZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-437-4988
Mailing Address - Street 1:1739 W FAIRMONT ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-3189
Mailing Address - Country:US
Mailing Address - Phone:610-437-4988
Mailing Address - Fax:610-437-4176
Practice Address - Street 1:1739 W FAIRMONT ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-3189
Practice Address - Country:US
Practice Address - Phone:610-437-4988
Practice Address - Fax:610-437-4176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0412930001Medicare NSC