Provider Demographics
NPI:1750452835
Name:CAPALONGO, DINA F (DO)
Entity Type:Individual
Prefix:DR
First Name:DINA
Middle Name:F
Last Name:CAPALONGO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE MEDICAL CENTER BLVD
Mailing Address - Street 2:ACP 532
Mailing Address - City:UPLAND
Mailing Address - State:PA
Mailing Address - Zip Code:19013
Mailing Address - Country:US
Mailing Address - Phone:610-447-6788
Mailing Address - Fax:610-876-2407
Practice Address - Street 1:ONE MEDICAL CENTER BLVD
Practice Address - Street 2:ACP 532
Practice Address - City:UPLAND
Practice Address - State:PA
Practice Address - Zip Code:19013
Practice Address - Country:US
Practice Address - Phone:610-447-6788
Practice Address - Fax:610-876-2407
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS007659L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001522805Medicaid
PA776458Medicare ID - Type Unspecified
PAG05733Medicare UPIN