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General NPI Number Information
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NPI Number | 1841563574
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Entity Type | Organization
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Legal Business Name | ST. LUKE'S WARREN PHYSICIAN GROUP, PC
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Dates
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Enumeration Date | 02/10/2012
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Last Update Date | 07/15/2021
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Provider Practice Location Address
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Address Line | 59 ROSEBERRY ST
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City | PHILLIPSBURG
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State | NJ
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Zip | 08865-1627
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Country | US
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Telephone | 908-847-4025
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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 | 484-526-4000
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | KRISTIN KEMMERER
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Credential |
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Telephone | 484-526-2019
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084S0012X
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Taxonomy Name | Sleep Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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