Provider Demographics
NPI:1598704306
Name:DI CARLO, ALFONSO (DC)
Entity Type:Individual
Prefix:DR
First Name:ALFONSO
Middle Name:
Last Name:DI CARLO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4540 HAMILTON BLVD
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-6195
Mailing Address - Country:US
Mailing Address - Phone:610-366-1336
Mailing Address - Fax:610-366-1397
Practice Address - Street 1:4540 HAMILTON BLVD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6195
Practice Address - Country:US
Practice Address - Phone:610-366-1336
Practice Address - Fax:610-366-1397
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007846L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA7189224OtherAETNA
PA043389OtherMEDICARE
PA043389OtherMEDICARE
PA140024Medicare PIN