Provider Demographics
NPI:1275515686
Name:ALLENTOWN RADIATION ONCOLOGY ASSOCIATES PC
Entity Type:Organization
Organization Name:ALLENTOWN RADIATION ONCOLOGY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDREWS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-402-0700
Mailing Address - Street 1:1020A E BOAL AVE
Mailing Address - Street 2:
Mailing Address - City:BOALSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16827-1509
Mailing Address - Country:US
Mailing Address - Phone:814-237-8627
Mailing Address - Fax:814-238-0083
Practice Address - Street 1:CEDAR CREST & I78
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6248
Practice Address - Country:US
Practice Address - Phone:610-402-0700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012359320007Medicaid
PA1029368OtherAMERIHEALTH MERCY
PA1029368OtherKEYSTONE MERCY
PA12140OtherUSHC
PA0498523000OtherKEYSTONE HEALTH PLAN EAST
PA1527166OtherGATEWAY HEALTH PLAN
PA0666015OtherKEYSTONE HEALTH PLAN CENT
PA402COtherGEISINGER HEALTH PLAN
PA666015OtherBCBS PA
PA0012359320007Medicaid