MEDICARE: DR. PETER J SCORDILIS DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	38MC00645800	NJ

General Provider Information

NPI Number	:	1043318785
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER J SCORDILIS DC

Provider Business Mailing Address
First Line	:	300 BROADACRES DR
Second Line	:
City	:	BLOOMFIELD
State	:	NJ
Zip	:	07003-3153
Country	:	US
Telephone Number	:	973-473-4481
Fax Number	:	973-893-8259

Provider Business Practice Location Address
First Line	:	300 BROADACRES DR
Second Line	:
City	:	BLOOMFIELD
State	:	NJ
Zip	:	07003-3153
Country	:	US
Telephone Number	:	973-473-4481
Fax Number	:	973-893-8259

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	09/13/2025

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