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General NPI Number Information
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NPI Number | 1538666789
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Entity Type | Organization
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Legal Business Name | JOSEPH A. DICONCETTO, MD, PC
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Dates
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Enumeration Date | 04/12/2018
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 5325 NORTHGATE DR STE 104
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City | BETHLEHEM
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State | PA
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Zip | 18017-9412
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Country | US
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Telephone | 610-691-2221
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Fax | 610-865-5655
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Provider Business Mailing Address
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Address Line | 5325 NORTHGATE DR STE 104
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City | BETHLEHEM
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State | PA
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Zip | 18017-9412
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Country | US
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Telephone | 610-691-2221
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Fax | 610-865-5655
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. JOSEPH ANTHONY DICONCETTO
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Credential | MD
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Telephone | 610-691-2221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RA0201X
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Taxonomy Name | Allergy & Immunology (Internal Medicine) Physician
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License Number | MD025018E
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License Number State | PA
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