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Organization
ST. LUKE'S PHYSICIAN GROUP, INC.
Active
Organization
ST. LUKE'S PHYSICIAN GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN CHIAVAROLI (CVO SUPERVISOR)
(484) 526-3569
Entity
Organization
Contact information
Practice address
143 N RAILROAD ST, TAMAQUA, PA 18252-1330
(484) 526-4000
Mailing address
801 OSTRUM ST, BETHLEHEM, PA 18015-1000
(570) 645-1540
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007307530232
—
PA
Enumeration date
09/20/2006
Last updated
06/24/2021
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