Healthcare Provider Details

I. General information

NPI: 1902950512
Provider Name (Legal Business Name): SCAGLIONE PROSTHETICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 09/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

514 BROAD ST
UTICA NY
13501-1207
US

IV. Provider business mailing address

514 BROAD ST
UTICA NY
13501-1207
US

V. Phone/Fax

Practice location:
  • Phone: 315-793-8331
  • Fax: 315-793-8332
Mailing address:
  • Phone: 315-793-8331
  • Fax: 315-793-8332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. RONALD J SCAGLIONE
Title or Position: PRESIDENT
Credential: CP
Phone: 315-793-8331