Healthcare Provider Details

I. General information

NPI: 1679819932
Provider Name (Legal Business Name): LARRY PAUL SCAFURI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2012
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 BIRNIE AVE
SPRINGFIELD MA
01107-1107
US

IV. Provider business mailing address

704 WOODGATE CIR
ENFIELD CT
06082-5582
US

V. Phone/Fax

Practice location:
  • Phone: 413-230-1270
  • Fax:
Mailing address:
  • Phone: 413-478-5417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA8430
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: