Healthcare Provider Details
I. General information
NPI: 1447341920
Provider Name (Legal Business Name): ANTHONY CHARLES SCISCIONE D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/27/2006
Last Update Date: 12/22/2023
Certification Date: 12/08/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 CENTURIAN DR SUITE 312
NEWARK DE
19713-2137
US
IV. Provider business mailing address
1 CENTURIAN DR SUITE 312
NEWARK DE
19713-2137
US
V. Phone/Fax
- Phone: 302-319-5680
- Fax: 302-319-5681
- Phone: 302-319-5680
- Fax: 302-319-5681
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VM0101X |
| Taxonomy | Maternal & Fetal Medicine Physician |
| License Number | C2-0003420 |
| License Number State | DE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: