Provider Demographics
NPI:1801929096
Name:DIMAGGIO, CALOGERO (DO)
Entity type:Individual
Prefix:DR
First Name:CALOGERO
Middle Name:
Last Name:DIMAGGIO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:CHARLIE
Other - Middle Name:
Other - Last Name:DIMAGGIO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:95 HIGHLAND AVE
Mailing Address - Street 2:SUITE 130
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-9424
Mailing Address - Country:US
Mailing Address - Phone:610-868-1100
Mailing Address - Fax:610-868-1111
Practice Address - Street 1:95 HIGHLAND AVE
Practice Address - Street 2:SUITE 130
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-9424
Practice Address - Country:US
Practice Address - Phone:610-868-1100
Practice Address - Fax:610-868-1111
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS0160002086S0129X
DEC70003259208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEC70003259OtherLICENSE