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General NPI Number Information
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NPI Number | 1275802944
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Entity Type | Organization
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Legal Business Name | ST. LUKE'S PHYSICIAN GROUP, INC
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Dates
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Enumeration Date | 12/23/2011
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Last Update Date | 05/02/2024
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Provider Practice Location Address
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Address Line | 1872 ST LUKES BLVD
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City | EASTON
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State | PA
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Zip | 18045-5669
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Country | US
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Telephone | 610-691-3335
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Fax |
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Provider Business Mailing Address
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Address Line | 801 OSTRUM ST
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City | BETHLEHEM
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State | PA
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Zip | 18015-1000
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Country | US
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Telephone | 844-562-4000
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | SUSAN CHIAVAROLI
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Credential |
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Telephone | 845-263-5694
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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