Healthcare Provider Details

I. General information

NPI: 1386621688
Provider Name (Legal Business Name): VITO J DICAMILLO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2005
Last Update Date: 05/13/2024
Certification Date: 05/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2118 SPRING VALLEY RD
LANCASTER PA
17601-2427
US

IV. Provider business mailing address

2118 SPRING VALLEY RD
LANCASTER PA
17601-2427
US

V. Phone/Fax

Practice location:
  • Phone: 717-544-0150
  • Fax: 717-544-0151
Mailing address:
  • Phone: 717-544-0150
  • Fax: 717-544-0151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD066259L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD066259L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: