Healthcare Provider Details

I. General information

NPI: 1427797190
Provider Name (Legal Business Name): VIRGINIA BERSANI D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VIRGINIA STODDARD-MERRIAM D.O.

II. Dates (important events)

Enumeration Date: 06/01/2022
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

834 EATON AVE STE 201
BETHLEHEM PA
18018-1832
US

IV. Provider business mailing address

834 EATON AVE STE 201
BETHLEHEM PA
18018-1832
US

V. Phone/Fax

Practice location:
  • Phone: 484-658-5437
  • Fax:
Mailing address:
  • Phone: 484-658-5437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberOS024812
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: