Healthcare Provider Details

I. General information

NPI: 1063376978
Provider Name (Legal Business Name): GEMMA ROSINA BOZZI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

539 CENTER ST
BETHLEHEM PA
18018-5910
US

IV. Provider business mailing address

2182 RIDGE RD
BANGOR PA
18013-5441
US

V. Phone/Fax

Practice location:
  • Phone: 484-896-9161
  • Fax: 484-251-5150
Mailing address:
  • Phone: 484-626-2859
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: