MEDICARE: MR. JOHN V SCALERA MD

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	208800000X	Urology Physician	25MA03934300	NJ

General Provider Information

NPI Number	:	1326009192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN V SCALERA MD

Provider Business Mailing Address
First Line	:	1750 ZION RD
Second Line	:
City	:	NORTHFIELD
State	:	NJ
Zip	:	08225-1844
Country	:	US
Telephone Number	:	609-484-7557
Fax Number	:	609-484-0939

Provider Business Practice Location Address
First Line	:	1750 ZION RD
Second Line	:
City	:	NORTHFIELD
State	:	NJ
Zip	:	08225-1844
Country	:	US
Telephone Number	:	609-484-7557
Fax Number	:	609-484-0939

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

Provider Enumeration Date	:	03/31/2006
Last Update Date	:	07/08/2007

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