Basic Information
Provider Information
NPI: 1306482526
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SALIB
FirstName: ROCHELLE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1605 N CEDAR CREST BLVD STE 411
Address2:  
City: ALLENTOWN
State: PA
PostalCode: 181042323
CountryCode: US
TelephoneNumber: 4848844500
FaxNumber:  
Practice Location
Address1: 1200 S CEDAR CREST BLVD
Address2:  
City: ALLENTOWN
State: PA
PostalCode: 181036202
CountryCode: US
TelephoneNumber: 6104025369
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/22/2019
LastUpdateDate: 11/22/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363AM0700XOA005022PAY Physician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical

No ID Information.


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