Healthcare Provider Details

I. General information

NPI: 1487683751
Provider Name (Legal Business Name): CHARLES J. SCAGLIOTTI, MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 S CEDAR CREST BLVD SUITE 3000
ALLENTOWN PA
18103-6229
US

IV. Provider business mailing address

1210 S. CEDAR CREST BLVD. SUITE 3000
ALLENTOWN PA
18103
US

V. Phone/Fax

Practice location:
  • Phone: 610-770-3270
  • Fax: 610-432-3249
Mailing address:
  • Phone: 610-770-3270
  • Fax: 610-432-3249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD428579
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD032904L
License Number StatePA

VIII. Authorized Official

Name: MRS. CHERYL A. MERCIER
Title or Position: OFFICE MANAGER
Credential: CMA
Phone: 610-770-3270