1053373514 NPI number — DR. STEVEN R SCIUTO D.C.

Table of content: DR. STEVEN R SCIUTO D.C. (NPI 1053373514)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053373514 NPI number — DR. STEVEN R SCIUTO D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCIUTO
Provider First Name:
STEVEN
Provider Middle Name:
R
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
M

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:
1053373514
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/28/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 MILK ST STE 8
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
METHUEN
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01844-4600
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-984-6636
Provider Business Mailing Address Fax Number:
978-984-6486

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 MILK ST STE 8
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
METHUEN
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01844-4600
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-984-6636
Provider Business Practice Location Address Fax Number:
978-984-6486
Provider Enumeration Date:
04/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  1232 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 111N00000X , with the licence number: 278-687A , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 111N00000X , with the licence number: CHI1232 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0508732Y0MA01 . This is a "ANTHEM BC/BS NH" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 351136 . This is a "HARVARD PILGRIM HEALTHCAR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 14554 . This is a "COST CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 969258 . This is a "NETWORK HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1608703 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 125592 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 727333 . This is a "TUFTS HEALTH PLANS" identifier . This identifiers is of the category "OTHER".
  • Identifier: Y35857 . This is a "BLUECROSSBLUE SHIELD MA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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