Basic Information
Provider Information
NPI: 1811548126
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZIEGLER
FirstName: JOHANNA
MiddleName:  
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Mailing Information
Address1: 1605 N CEDAR CREST BLVD STE 411
Address2:  
City: ALLENTOWN
State: PA
PostalCode: 181042323
CountryCode: US
TelephoneNumber: 4848844500
FaxNumber: 4846647659
Practice Location
Address1: 1250 S CEDAR CREST BLVD STE 110
Address2:  
City: ALLENTOWN
State: PA
PostalCode: 181036224
CountryCode: US
TelephoneNumber: 6104028900
FaxNumber: 6104025656
Other Information
ProviderEnumerationDate: 09/27/2019
LastUpdateDate: 09/27/2019
NPIDeactivationReasonCode:  
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NPIReactivationDate:  
ProviderGenderCode: F
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IsSoleProprietor: N
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363AM0700XMA061139PAY Physician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical

No ID Information.


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