Provider Demographics
NPI:1700873767
Name:LOBKO, STEPHEN E (CRNA)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:E
Last Name:LOBKO
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1245 S CEDAR CREST BLVD
Mailing Address - Street 2:SUITE #301
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-6258
Mailing Address - Country:US
Mailing Address - Phone:610-402-9099
Mailing Address - Fax:610-402-9029
Practice Address - Street 1:1200 S CEDAR CREST BLVD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6202
Practice Address - Country:US
Practice Address - Phone:610-402-9099
Practice Address - Fax:610-402-9029
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN275007L163W00000X
PA040904367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA11776581OtherCAQH
PA1344486OtherHIGHMARK
PA1344486OtherFIRST PRIORITY
PA2037051000OtherINDEP. BLUE CROSS
PA9491449OtherAETNA
PA03224101OtherCAPITAL ADVANTAGE
PA82860OtherGEISINGER
PA1027796280001Medicaid
PA1344485OtherKHP CENTRAL
PA1546056OtherGATEWAY
PA1027796280001Medicaid
PA82860OtherGEISINGER
PA1344486OtherHIGHMARK