Healthcare Provider Details

I. General information

NPI: 1437356441
Provider Name (Legal Business Name): ST. LUKE'S HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

153 BRODHEAD RD
BETHLEHEM PA
18017-8931
US

IV. Provider business mailing address

623 E BROAD ST
BETHLEHEM PA
18018-6332
US

V. Phone/Fax

Practice location:
  • Phone: 610-954-4780
  • Fax: 610-954-3216
Mailing address:
  • Phone: 610-954-6048
  • Fax: 610-954-3189

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PS0010X
TaxonomySports Medicine (Emergency Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2083S0010X
TaxonomySports Medicine (Preventive Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: THOMAS LICHTENWALNER
Title or Position: ASST VICE PRESIDENT
Credential:
Phone: 610-954-4991