Healthcare Provider Details

I. General information

NPI: 1336583731
Provider Name (Legal Business Name): FRANK J. SCACCIA M.D.,F.A.C.S.,L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2013
Last Update Date: 04/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 ROUTE 70 SUITE 3A
BRICK NJ
08723-4022
US

IV. Provider business mailing address

70 E FRONT ST SUITE 3
RED BANK NJ
07701-1851
US

V. Phone/Fax

Practice location:
  • Phone: 732-747-5300
  • Fax: 732-747-9922
Mailing address:
  • Phone: 732-747-5300
  • Fax: 732-747-9922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. FRANK J SCACCIA
Title or Position: MEDICAL DIRECTOR
Credential: M.D
Phone: 732-747-5300