Basic Information
Provider Information
NPI: 1346593498
EntityType: 2
ReplacementNPI:  
OrganizationName: CHS PROFESSIONAL PRACTICE, P.C.
LastName:  
FirstName:  
MiddleName:  
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Credential:  
OtherOrganizationName: COORDINATED HEALTH-ENDOCRINOLOGY
OtherOrganizationType: 3
OtherLastName:  
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Mailing Information
Address1: 2775 SCHOENERSVILLE RD
Address2:  
City: BETHLEHEM
State: PA
PostalCode: 180177307
CountryCode: US
TelephoneNumber: 6108618080
FaxNumber: 6108610854
Practice Location
Address1: 2300 HIGHLAND AVE
Address2:  
City: BETHLEHEM
State: PA
PostalCode: 180208920
CountryCode: US
TelephoneNumber: 6108618080
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/25/2012
LastUpdateDate: 02/11/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
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ProviderGenderCode:  
AuthorizedOfficialLastName: DIIORIO
AuthorizedOfficialFirstName: EMIL
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: MEDICAL DIRECTOR
AuthorizedOfficialTelephone: 6108618080
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential: MD

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RE0101X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism

No ID Information.


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