1811811060 NPI number — SCARDINO INDEPENDENT SERVICE COORDINATION LLC

Table of content: (NPI 1811811060)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811811060 NPI number — SCARDINO INDEPENDENT SERVICE COORDINATION LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SCARDINO INDEPENDENT SERVICE COORDINATION LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1811811060
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/08/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1320
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BUFFALO
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14226-7320
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-863-9968
Provider Business Mailing Address Fax Number:
716-409-4344

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16 PATRICIA DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TONAWANDA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14150-4617
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-863-9968
Provider Business Practice Location Address Fax Number:
716-409-4344
Provider Enumeration Date:
08/08/2026

Additional Information

Authorized Official

Authorized Official Last Name:
SCARDINO GODZIK
Authorized Official First Name:
WARD
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT/CEO/SERVICE COORDINATOR
Authorized Official Telephone Number:
716-863-9968

Provider Taxonomy Codes

  • Taxonomy code: 171M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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