Healthcare Provider Details

I. General information

NPI: 1215233341
Provider Name (Legal Business Name): ROBERT SCARLATELLI,M.D.,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2011
Last Update Date: 02/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 RESNIK RD LOWER LEVEL
PLYMOUTH MA
02360-7211
US

IV. Provider business mailing address

30 RESNIK RD LOWER LEVEL
PLYMOUTH MA
02360-7211
US

V. Phone/Fax

Practice location:
  • Phone: 508-746-2900
  • Fax: 508-746-4208
Mailing address:
  • Phone: 508-746-2900
  • Fax: 508-746-4208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT ANTHONY SCARLATELLI
Title or Position: OWNER
Credential: MD
Phone: 508-746-2900