Healthcare Provider Details

I. General information

NPI: 1598944936
Provider Name (Legal Business Name): DAVID A SCALZO D.P.M.,P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2007
Last Update Date: 08/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 FOOTE AVE
DURYEA PA
18642-1408
US

IV. Provider business mailing address

203 FOOTE AVE
DURYEA PA
18642-1408
US

V. Phone/Fax

Practice location:
  • Phone: 570-457-4560
  • Fax: 570-457-4562
Mailing address:
  • Phone: 570-457-4560
  • Fax: 570-457-4562

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSC004196L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberSC004196L
License Number StatePA

VIII. Authorized Official

Name: DR. DAVID A SCALZO
Title or Position: DOCTOR
Credential: DPM
Phone: 570-457-4560