Organization
ST. LUKE'S PHYSICIAN GROUP, INC
Active
Other names
St. Luke's General Surgery Miners
Organization subpart
No
Provider details
NPI number
Authorized official
TAMI GIGLIO (ENROLLMENT SPECIALIST)
(484) 526-3571
Entity
Organization
Contact information
Practice address
360 W RUDDLE ST, COALDALE, PA 18218-1027
(484) 526-2200
(484) 526-2398
Mailing address
801 OSTRUM ST, BETHLEHEM, PA 18015-1000
(484) 526-3571
(833) 213-6428
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
2086S0102X
Surgical Critical Care Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
034134
MEDICARE
PA
Enumeration date
05/22/2019
Last updated
08/25/2021
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