Basic Information
Provider Information
NPI: 1003803933
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BINDER
FirstName: GREGORY
MiddleName: J.
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1245 S CEDAR CREST BLVD
Address2: SUITE #301
City: ALLENTOWN
State: PA
PostalCode: 181036258
CountryCode: US
TelephoneNumber: 6104029099
FaxNumber: 6104029029
Practice Location
Address1: 17TH & CHEW STREET
Address2:  
City: ALLENTOWN
State: PA
PostalCode: 18102
CountryCode: US
TelephoneNumber: 6104029099
FaxNumber: 6104029029
Other Information
ProviderEnumerationDate: 10/05/2005
LastUpdateDate: 03/25/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000XRN240181LPAN Nursing Service ProvidersRegistered Nurse 
367500000X041298PAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

ID Information
IDTypeStateIssuerDescription
979647701PAAETNAOTHER
0322130101PACAPITAL ADVANTAGEOTHER
134316901PAHIGHMARKOTHER
203583800001PAINDEP. BLUE CROSSOTHER
8283301PAGEISINGEROTHER
102779931000105PA MEDICAID
134316901PAKHP CENTRALOTHER
158143801 GATEWAYOTHER
1171689601PACAQHOTHER
134316901PAFIRST PRIORITYOTHER


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