Provider Demographics
NPI:1962456319
Name:LEHIGH VALLEY FAMILY PRACTICE ASSOCIATES, LLP
Entity Type:Organization
Organization Name:LEHIGH VALLEY FAMILY PRACTICE ASSOCIATES, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:D
Authorized Official - Last Name:KANE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:610-694-9090
Mailing Address - Street 1:190 BRODHEAD RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-8617
Mailing Address - Country:US
Mailing Address - Phone:610-694-9090
Mailing Address - Fax:610-861-8295
Practice Address - Street 1:190 BRODHEAD RD
Practice Address - Street 2:SUITE 101
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-8617
Practice Address - Country:US
Practice Address - Phone:610-694-9090
Practice Address - Fax:610-861-8295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA207Q00000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA092995OtherAETNA
PA0166196OtherKEYSTONE CENTRAL
PA02350700OtherCAPITAL BLUE CROSS
PA0000166196OtherHIGHMARK BLUE SHIELD
PA0166196OtherPERSONAL CHOICE
PA001716003001Medicaid
PA166196OtherINTERCOUNTY
PACN1759OtherRAILROAD MEDICARE
PAE1BXOtherVALLEY PREFERRED GEISINGE
PA001716003001Medicaid
PA166196OtherINTERCOUNTY