Organization
ST. LUKE'S PHYSICIAN GROUP, INC.
Active
Organization
ST. LUKE'S PHYSICIAN GROUP, INC.
Active
Parent organization
ST. LUKE'S PHYSICIAN GROUP, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST. LUKE'S PHYSICIAN GROUP, INC.
Authorized official
SUE CHIAVAROLI (SUPERVISOR, CVO ENROLLMENT)
(484) 526-3569
Entity
Organization
Contact information
Practice address
257 BRODHEAD RD, BETHLEHEM, PA 18017-8938
(484) 526-2400
Mailing address
77 S COMMERCE WAY, BETHLEHEM, PA 18017-8891
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
09/02/2020
Last updated
09/02/2020
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