1922083484 NPI number — GRETCHEN A SCALPI R.D., CDE

Table of content: GRETCHEN A SCALPI R.D., CDE (NPI 1922083484)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922083484 NPI number — GRETCHEN A SCALPI R.D., CDE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCALPI
Provider First Name:
GRETCHEN
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
R.D., CDE
Provider Gender Code:
F

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:
1922083484
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
386 LIBERTY ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BEACON
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12508-2103
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-831-7258
Provider Business Mailing Address Fax Number:
845-831-5178

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
386 LIBERTY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BEACON
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12508-2103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-831-7258
Provider Business Practice Location Address Fax Number:
845-831-5178
Provider Enumeration Date:
12/07/2005

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: 133V00000X , with the licence number:  001356-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: P2392735 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000087976 . This is a "GHI HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 9152E1 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 9740994 . This is a "GHI PPO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2149978 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5C6218 . This is a "HEALTHNET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 714023 . This is a "MVP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7153232 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9418630 . This is a "PHCS" identifier . This identifiers is of the category "OTHER".




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