1487683751 NPI number — CHARLES J. SCAGLIOTTI, MD

Table of content: (NPI 1487683751)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487683751 NPI number — CHARLES J. SCAGLIOTTI, MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHARLES J. SCAGLIOTTI, MD
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:
1487683751
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1210 S. CEDAR CREST BLVD.
Provider Second Line Business Mailing Address:
SUITE 3000
Provider Business Mailing Address City Name:
ALLENTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18103
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-770-3270
Provider Business Mailing Address Fax Number:
610-432-3249

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1210 S CEDAR CREST BLVD
Provider Second Line Business Practice Location Address:
SUITE 3000
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18103-6229
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-770-3270
Provider Business Practice Location Address Fax Number:
610-432-3249
Provider Enumeration Date:
06/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MERCIER
Authorized Official First Name:
CHERYL
Authorized Official Middle Name:
A.
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
610-770-3270

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  MD032904L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 208600000X , with the licence number: MD428579 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 02356100 . This is a "KEYSTONE CENTRAL" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1077454 . This is a "FIRST HEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1808787 . This is a "BLUE SHIELD PERSONAL CHOI" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2168732 . This is a "AETNA USHC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 127370 . This is a "THREE RIVERS & MED PLUS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 14339 . This is a "GEISINGER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 01004101 . This is a "CAPITAL BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0758760 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1526126 . This is a "GATEWAY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0040083000 . This is a "INDEPENDENCE BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1057378001 . This is a "CIGNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1106985 . This is a "AMERIHEALTH MERCY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 19260 . This is a "HEATLH ASSURANCE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2646498000 . This is a "KEYSTONE EAST" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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