MEDICARE: GRACE DIBARI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program		PA

General Provider Information

NPI Number	:	1184567174
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRACE DIBARI

Provider Business Mailing Address
First Line	:	4521 HARLING LN
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20814-4627
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2545 SCHOENERSVILLE RD
Second Line	:
City	:	BETHLEHEM
State	:	PA
Zip	:	18017-7300
Country	:	US
Telephone Number	:	610-402-8000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2026
Last Update Date	:	04/13/2026

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Directions to “ GRACE DIBARI ” Practice Location

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