Healthcare Provider Details

I. General information

NPI: 1124931654
Provider Name (Legal Business Name): MARY BEM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 OSTRUM ST
BETHLEHEM PA
18015-1000
US

IV. Provider business mailing address

1763 MADISON AVE APT 202
BETHLEHEM PA
18017-6010
US

V. Phone/Fax

Practice location:
  • Phone: 484-526-7800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN638725
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: