Provider Demographics
NPI:1477979680
Name:ST. LUKE'S HOSPITAL
Entity type:Organization
Organization Name:ST. LUKE'S HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SENIOR VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:LICHTENWALNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-526-3301
Mailing Address - Street 1:801 OSTRUM ST
Mailing Address - Street 2:ATTENTION VISION CLINIC
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015
Mailing Address - Country:US
Mailing Address - Phone:484-526-6204
Mailing Address - Fax:
Practice Address - Street 1:1530 8TH AVE
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-1883
Practice Address - Country:US
Practice Address - Phone:484-526-6204
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-12
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty