Healthcare Provider Details

I. General information

NPI: 1194353003
Provider Name (Legal Business Name): JOSEPH SCIACCA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2020
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4745 OGLETOWN STANTON ROAD SUITE 111
NEWARK DE
19718-2200
US

IV. Provider business mailing address

4745 OGLETOWN STANTON ROAD SUITE 111
NEWARK DE
19718-2200
US

V. Phone/Fax

Practice location:
  • Phone: 302-623-5444
  • Fax: 302-737-2697
Mailing address:
  • Phone: 302-623-5444
  • Fax: 302-737-2697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberC2-0024754
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: