Provider Demographics
NPI:1558697011
Name:A.J. DICESARO DC, LTD
Entity Type:Organization
Organization Name:A.J. DICESARO DC, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:DICESARO
Authorized Official - Suffix:III
Authorized Official - Credentials:DC
Authorized Official - Phone:412-885-2929
Mailing Address - Street 1:4500 CLAIRTON BLVD.
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15236
Mailing Address - Country:US
Mailing Address - Phone:412-885-2929
Mailing Address - Fax:412-253-0619
Practice Address - Street 1:4500 CLAIRTON BLVD.
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15236
Practice Address - Country:US
Practice Address - Phone:412-885-2929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-19
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC006431L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty