Healthcare Provider Details

I. General information

NPI: 1144817859
Provider Name (Legal Business Name): ALEXANDER JOHN GEBHARDT BS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2020
Last Update Date: 07/01/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2760 EMRICK BLVD
BETHLEHEM PA
18020-8012
US

IV. Provider business mailing address

251 ROBERT MORRIS BLVD APT 205
ALLENTOWN PA
18104-4572
US

V. Phone/Fax

Practice location:
  • Phone: 484-538-3995
  • Fax:
Mailing address:
  • Phone: 484-538-3995
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBH007794
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: