Healthcare Provider Details

I. General information

NPI: 1952359515
Provider Name (Legal Business Name): STEPHEN F. SCARANGELLA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 01/30/2024
Certification Date: 01/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 FOUNDERS ST STE 202
WILLIMANTIC CT
06226-2052
US

IV. Provider business mailing address

1111 CROMWELL AVE STE 403
ROCKY HILL CT
06067-3454
US

V. Phone/Fax

Practice location:
  • Phone: 860-456-3997
  • Fax:
Mailing address:
  • Phone: 860-525-4469
  • Fax: 860-999-9305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number039299
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number039299
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: