Travis J Dichoso, DO

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

OT018006 Issued in PA

Practice address

100 E Lehigh Ave Suite 305B
Philadelphia, PA 19125

Phone

(215) 707-3351

NPI assigned

Jun 2, 2017

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1496361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1063940187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LEHIGH AVE SUITE 305B",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19125",
            "telephone_number": "215-706-3351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LEHIGH AVE SUITE 305B",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19125",
            "telephone_number": "215-707-3351"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4641 Roosevelt Blvd Rm 218E",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191242343",
            "country_code": "US",
            "telephone_number": "410-419-2293",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICHOSO",
        "first_name": "TRAVIS",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084B0040X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": "PA",
            "license": "OT018006",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "OT018006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine M Dicataldo
• Bernadette B Diccion, CRNP
• Rema Dicen, CRNP
• Laura Dicesare, PSY.D.
• Christina Jacqueline Dichiara, PSY.D.
• Helene Morgan Dichter, PHD
• Marc A Dichter, MD
• Laura Dicianni, NP
• Jennalee Dicicco, DMD
• Lisa Dicicco, MSN CRNP

• Psychiatry Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Psychiatry Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.