Healthcare Provider Details

I. General information

NPI: 1831027986
Provider Name (Legal Business Name): GIOSUE SCACCIANOCE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JOSH SCACCIANOCE

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4909 GREEN RD
RALEIGH NC
27616-3418
US

IV. Provider business mailing address

4020 PASSENGER PL
DURHAM NC
27703-5664
US

V. Phone/Fax

Practice location:
  • Phone: 919-790-0288
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP24888
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: