Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 447159 | PA |
N | 2080P0207X | Pediatric Hematology-Oncologist | MD447159 | PA |
NPI | 1275714024 |
---|---|
Provider Name | Lydia A Boateng |
First Address | Allentown, PA 18104-2253 |
Second Address | Allentown, PA 18104-2253 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2007 |
Last Update Date | 15/08/2019 |