| Dicesare Orthopedic Medicine Llc | |
|
438 Pellis Rd Greensburg PA 15601-7900 | |
| (724) 261-4080 | |
| (724) 261-4081 |
| Full Name | Dicesare Orthopedic Medicine Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 438 Pellis Rd, Greensburg, Pennsylvania |
| Authorized Official Name and Position | Jacob A Dicesare (PRESIDENT) |
| Authorized Official Contact | 7242614080 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dicesare Orthopedic Medicine Llc Po Box 7 Bovard PA 15619-0007 Ph: (724) 261-4080 | Dicesare Orthopedic Medicine Llc 438 Pellis Rd Greensburg PA 15601-7900 Ph: (724) 261-4080 |
| NPI Number | 1114546736 |
|---|---|
| Provider Enumeration Date | 04/14/2020 |
| Last Update Date | 05/04/2020 |
| Medicare PECOS PAC ID | 3173954138 |
|---|---|
| Medicare Enrollment ID | O20200507003258 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114546736 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | (* (Not Available)) | Primary |
| Provider Name | Jacob A Dicesare |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1184862427 PECOS PAC ID: 8325189020 Enrollment ID: I20100104000058 |
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