Healthcare Provider Details

I. General information

NPI: 1376081489
Provider Name (Legal Business Name): MARIA SCARANO MS LCGC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2017
Last Update Date: 02/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 COOPER PLZ SUITE 309
CAMDEN NJ
08103-1438
US

IV. Provider business mailing address

3 COOPER PLZ SUITE 309
CAMDEN NJ
08103-1438
US

V. Phone/Fax

Practice location:
  • Phone: 856-968-7246
  • Fax:
Mailing address:
  • Phone: 856-968-7246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number25MJ00017800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: