1346257508 NPI number — DR. JOSEPH A SCALIA DO

Table of content: DR. JOSEPH A SCALIA DO (NPI 1346257508)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346257508 NPI number — DR. JOSEPH A SCALIA DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCALIA
Provider First Name:
JOSEPH
Provider Middle Name:
A
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DO
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:
1346257508
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/13/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 95000 LB# 7550
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19195-7550
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
844-362-1735
Provider Business Mailing Address Fax Number:
973-290-7495

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
346 SOUTH AVE
Provider Second Line Business Practice Location Address:
SUITE 6
Provider Business Practice Location Address City Name:
FANWOOD
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07023
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-889-8700
Provider Business Practice Location Address Fax Number:
908-889-7799
Provider Enumeration Date:
08/01/2006

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: 207Q00000X , with the licence number:  MB63033 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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