MEDICARE: DR. SALVATORE J. SCLAFANI M.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	2085R0202X	Diagnostic Radiology Physician	116360-1	NY
2	2085R0204X	Vascular & Interventional Radiology Physician	116360	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	:	1891771739
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SALVATORE J. SCLAFANI M.D.

Provider Business Mailing Address
First Line	:	PO BOX 416173
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02241-6173
Country	:	US
Telephone Number	:	610-644-8900
Fax Number	:	484-924-0053

Provider Business Practice Location Address
First Line	:	960 40TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-1518
Country	:	US
Telephone Number	:	718-369-1444
Fax Number	:

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

Provider Enumeration Date	:	12/22/2005
Last Update Date	:	07/18/2023

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