MEDICARE: DR. JOE SCROPPO PH.D.

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	103TC0700X	Clinical Psychologist	013277	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083698161
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOE SCROPPO PH.D.

Provider Business Mailing Address
First Line	:	JOE SCROPPO, PH.D., J.D.
Second Line	:	1209 E. BROADWAY UNIT D 14
City	:	HEWLETT
State	:	NY
Zip	:	11557-2429
Country	:	US
Telephone Number	:	516-791-1438
Fax Number	:	800-441-9772

Provider Business Practice Location Address
First Line	:	999 CENTRAL AVE STE 102
Second Line	:
City	:	WOODMERE
State	:	NY
Zip	:	11598-1205
Country	:	US
Telephone Number	:	516-791-1438
Fax Number	:	800-441-9772

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

Provider Enumeration Date	:	12/02/2005
Last Update Date	:	05/15/2020

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