Provider Demographics
NPI:1255302246
Name:CIMORELLI, LOUIS C JR (DO)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:C
Last Name:CIMORELLI
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:801 OSTRUM ST
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1000
Mailing Address - Country:US
Mailing Address - Phone:484-526-6048
Mailing Address - Fax:484-526-6500
Practice Address - Street 1:4379 EASTON AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-1483
Practice Address - Country:US
Practice Address - Phone:610-814-2424
Practice Address - Fax:610-814-2425
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0102201477207Q00000X
MA240013207Q00000X
PAOS015344207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA686024OtherMEDICARE GROUP
MA0013015Medicare UPIN
MA001301501Medicare UPIN