Healthcare Provider Details

I. General information

NPI: 1053514653
Provider Name (Legal Business Name): SCOTT EVAN SPAGNOLO-HYE D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2007
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 S MAIN RD
VINELAND NJ
08360-7897
US

IV. Provider business mailing address

42 E LAUREL RD UDP #1700
STRATFORD NJ
08084-1354
US

V. Phone/Fax

Practice location:
  • Phone: 856-293-6974
  • Fax: 856-825-6165
Mailing address:
  • Phone: 856-566-7010
  • Fax: 856-566-6956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS10552
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number238708
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberOS10552
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MB09887900
License Number StateNJ
# 5
Primary TaxonomyN
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License NumberOS10552
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number25MB09887900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: