Healthcare Provider Details

I. General information

NPI: 1205772472
Provider Name (Legal Business Name): ELENA GABRIELA SIERRA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 OSTRUM ST STE 1
BETHLEHEM PA
18015-1065
US

IV. Provider business mailing address

801 OSTRUM ST STE 1
BETHLEHEM PA
18015-1065
US

V. Phone/Fax

Practice location:
  • Phone: 484-503-8217
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMT236504
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: