Provider Demographics
NPI:1487960639
Name:SPECIALTY PHYSICIAN ASSOCIATES, LLC
Entity type:Organization
Organization Name:SPECIALTY PHYSICIAN ASSOCIATES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:YEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-866-5555
Mailing Address - Street 1:3445 HIGH POINT BLVD.
Mailing Address - Street 2:SUITE 400
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-7817
Mailing Address - Country:US
Mailing Address - Phone:610-866-5555
Mailing Address - Fax:610-866-3151
Practice Address - Street 1:3445 HIGH POINT BLVD., SUITE 400
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-7817
Practice Address - Country:US
Practice Address - Phone:610-866-5555
Practice Address - Fax:610-866-3151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-26
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic AllergyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
214747Medicare PIN