Healthcare Provider Details

I. General information

NPI: 1982972188
Provider Name (Legal Business Name): ROBERT A SCARAMUCCI MS,OTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2011
Last Update Date: 12/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 SUNRISE HWY
PATCHOGUE NY
11772-1868
US

IV. Provider business mailing address

201 SUNRISE HIGHWAY
PATCHOUGUE NY
11772
US

V. Phone/Fax

Practice location:
  • Phone: 631-218-4180
  • Fax:
Mailing address:
  • Phone: 631-218-4180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number009056-1
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: