MEDICARE: CRYSTAL SCATTAREGGIA CRNP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	SP034051	PA
2	363LF0000X	Family Nurse Practitioner	SP016829	PA

General Provider Information

NPI Number	:	1649715418
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRYSTAL SCATTAREGGIA CRNP

Provider Business Mailing Address
First Line	:	202 HIGHLAND AVE
Second Line	:
City	:	LANSDALE
State	:	PA
Zip	:	19446-3209
Country	:	US
Telephone Number	:	570-951-9375
Fax Number	:	803-281-3772

Provider Business Practice Location Address
First Line	:	900 LENMAR DR STE B
Second Line	:
City	:	BLUE BELL
State	:	PA
Zip	:	19422-2049
Country	:	US
Telephone Number	:	445-447-2946
Fax Number	:	803-281-3772

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

Provider Enumeration Date	:	01/03/2017
Last Update Date	:	02/05/2026

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