Healthcare Provider Details

I. General information

NPI: 1669988101
Provider Name (Legal Business Name): ST. LUKE'S WARREN PHYSICIAN GROUP, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2017
Last Update Date: 02/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 ROSEBERRY ST
PHILLIPSBURG NJ
08865-1690
US

IV. Provider business mailing address

185 ROSEBERRY ST
PHILLIPSBURG NJ
08865-1690
US

V. Phone/Fax

Practice location:
  • Phone: 484-526-2464
  • Fax: 484-526-2266
Mailing address:
  • Phone: 908-847-2621
  • Fax: 908-847-3045

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: GERARD DELMONICO
Title or Position: OWNER
Credential: MD
Phone: 908-847-6568