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NPI Code Detail

MEDICARE: MR. GERARD JOSEPH SCIBILIA MPT

MEDICARE: MR. GERARD JOSEPH SCIBILIA MPT
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
1225100000XPhysical Therapist3301SC
22251H1200XHand Physical Therapist3301SC
32251N0400XNeurology Physical Therapist3301SC
42251X0800XOrthopedic Physical Therapist3301SC
52255A2300XAthletic Trainer399SC
6225100000XPhysical Therapist23300MD

General Provider Information

NPI Number : 1851394977
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. GERARD JOSEPH SCIBILIA MPT
Provider Business Mailing Address
First Line : 790 REMINGTON BLVD
Second Line :
City : BOLINGBROOK
State : IL
Zip : 60440-4909
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 910 FREDERICK RD
Second Line :
City : CATONSVILLE
State : MD
Zip : 21228-4516
Country : US
Telephone Number : 410-644-1880
Fax Number : 410-646-3623
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 06/05/2024

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