Organization
DICESARE ORTHOPEDIC MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB A DICESARE MD (PRESIDENT)
(724) 261-4080
Entity
Organization
Contact information
Practice address
438 PELLIS RD, GREENSBURG, PA 15601-7900
(724) 261-4080
(724) 261-4081
Mailing address
PO BOX 7, BOVARD, PA 15619-0007
(724) 261-4080
(412) 261-4081
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
04/14/2020
Last updated
05/04/2020
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