Organization
ST. LUKE'S PHYSICIAN GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUE CHIAVAROLI (MANAGER)
(484) 526-3569
Entity
Organization
Contact information
Practice address
257 BRODHEAD RD, BETHLEHEM, PA 18017-8938
(484) 822-5700
Mailing address
801 OSTRUM ST, BETHLEHEM, PA 18015-1000
(484) 526-2400
(484) 526-3697
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007307530002
—
PA
Enumeration date
07/26/2006
Last updated
05/05/2023
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