Basic Information
| Provider Information | |||||||||
| NPI: | 1629008834 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | EASTON ORTHOPAEDIC GROUP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3101 EMRICK BLVD | ||||||||
| Address2: | SUITE 112 | ||||||||
| City: | BETHLEHEM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180208037 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6109975750 | ||||||||
| FaxNumber: | 6109975762 | ||||||||
| Practice Location | |||||||||
| Address1: | 3101 EMRICK BLVD | ||||||||
| Address2: | SUITE 112 | ||||||||
| City: | BETHLEHEM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180208037 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6109975750 | ||||||||
| FaxNumber: | 6109975762 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/04/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | BUCHMAN | ||||||||
| AuthorizedOfficialFirstName: | CYNTHIA | ||||||||
| AuthorizedOfficialMiddleName: | A. | ||||||||
| AuthorizedOfficialTitleorPosition: | PRACTICE ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 6109955750 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | Y | 193200000X MULTI-SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.