Provider Demographics
NPI:1679552418
Name:DICONCETTO, JOSEPH A (MD)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:A
Last Name:DICONCETTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1999 W POINT DR
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-5156
Mailing Address - Country:US
Mailing Address - Phone:610-691-2221
Mailing Address - Fax:610-865-5655
Practice Address - Street 1:5325 NORTHGATE DR
Practice Address - Street 2:SUITE 104
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-9411
Practice Address - Country:US
Practice Address - Phone:610-691-2221
Practice Address - Fax:610-865-5655
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-11
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD025018E207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA190451OtherHIGHMARK
PA7065375Medicaid
PA01189201OtherCAPITAL BLUE CROSS
PA2256060OtherAETNA
PA01189201OtherCAPITAL BLUE CROSS
PA7065375Medicaid