Provider Demographics
NPI:1306051925
Name:DICASIMIRRO, BERNARD JAMES (DO)
Entity type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:JAMES
Last Name:DICASIMIRRO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19067-1073
Mailing Address - Country:US
Mailing Address - Phone:215-815-7851
Mailing Address - Fax:
Practice Address - Street 1:825 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:PA
Practice Address - Zip Code:19067-1073
Practice Address - Country:US
Practice Address - Phone:215-815-7851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS007996L2084P0015X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine