Healthcare Provider Details

I. General information

NPI: 1336383736
Provider Name (Legal Business Name): KYLA J SCARPONI D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2009
Last Update Date: 04/15/2022
Certification Date: 04/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 HOSPITAL DR SUITE D
YORK ME
03909-1011
US

IV. Provider business mailing address

1 BRICKYARD LN STE B
YORK ME
03909-1687
US

V. Phone/Fax

Practice location:
  • Phone: 207-351-1710
  • Fax:
Mailing address:
  • Phone: 207-606-2032
  • Fax: 207-606-2039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number238916
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2158
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: