1801929096 NPI number — DR. CALOGERO DIMAGGIO DO

Table of content: DR. CALOGERO DIMAGGIO DO (NPI 1801929096)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801929096 NPI number — DR. CALOGERO DIMAGGIO DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DIMAGGIO
Provider First Name:
CALOGERO
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DIMAGGIO
Provider Other First Name:
CHARLIE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
DO
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1801929096
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/18/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
95 HIGHLAND AVE
Provider Second Line Business Mailing Address:
SUITE 130
Provider Business Mailing Address City Name:
BETHLEHEM
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18017-9424
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-868-1100
Provider Business Mailing Address Fax Number:
610-868-1111

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
95 HIGHLAND AVE
Provider Second Line Business Practice Location Address:
SUITE 130
Provider Business Practice Location Address City Name:
BETHLEHEM
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18017-9424
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-868-1100
Provider Business Practice Location Address Fax Number:
610-868-1111
Provider Enumeration Date:
03/14/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2086S0129X , with the licence number:  OS016000 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 208600000X , with the licence number: C70003259 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: C70003259 . This is a "LICENSE" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".




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