Healthcare Provider Details

I. General information

NPI: 1285061630
Provider Name (Legal Business Name): ST. LUKE'S WARREN PHYSICIAN GROUP, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2013
Last Update Date: 01/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 MEMORIAL PKWY SUITE 106
PHILLIPSBURG NJ
08865-2748
US

IV. Provider business mailing address

755 MEMORIAL PKWY STE 106
PHILLIPSBURG NJ
08865-2774
US

V. Phone/Fax

Practice location:
  • Phone: 908-859-0514
  • Fax: 908-859-0515
Mailing address:
  • Phone: 908-847-0514
  • Fax: 866-285-6806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GERARD DELMONICO
Title or Position: OWNER
Credential: MD
Phone: 908-859-6568