Provider Demographics
NPI:1922396704
Name:LENGEL, DIANA ALDERFER (MSN/FNP)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:ALDERFER
Last Name:LENGEL
Suffix:
Gender:F
Credentials:MSN/FNP
Other - Prefix:
Other - First Name:DIANA
Other - Middle Name:CAROLE
Other - Last Name:ALDERFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN/FNP
Mailing Address - Street 1:PO BOX 1754
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18105-1754
Mailing Address - Country:US
Mailing Address - Phone:484-884-4500
Mailing Address - Fax:484-884-0699
Practice Address - Street 1:365 S CEDAR CREST BLVD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-3600
Practice Address - Country:US
Practice Address - Phone:484-664-2046
Practice Address - Fax:484-664-2047
Is Sole Proprietor?:No
Enumeration Date:2011-07-14
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP011278363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASP011278OtherPA STATE LICENSE