Individual provider Active NPI

Laura L Bielecki, PA-C

  • Physician Assistant
  • Allentown, PA
National Provider Identifier
1770581365
Registry record updated May 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA003373L Issued in PA
Practice address
1605 N Cedar Crest Blvd Ste 110B
Allentown, PA 18104-2351
Phone
(610) 973-1410
Fax
(610) 973-1449
NPI assigned
Jul 8, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA003373L PA Primary

Addresses

Primary practice location

1605 N Cedar Crest Blvd Ste 110B
Allentown, PA 18104-2351

Mailing address

1605 N Cedar Crest Blvd Ste 110B
Allentown, PA 18104-2351
Phone (610) 973-1410

Other names 1

  • Laura L Mack Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA003373LPAMDPhysician Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556668800000",
    "number": "1770581365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 N CEDAR CREST BLVD STE 110B",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181042351",
            "telephone_number": "610-973-1410",
            "fax_number": "610-973-1449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 N CEDAR CREST BLVD STE 110B",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181042351",
            "telephone_number": "610-973-1410",
            "fax_number": "610-973-1449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIELECKI",
        "first_name": "LAURA",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-08",
        "last_updated": "2019-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA003373L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "MACK",
            "middle_name": "L",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Allentown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.