Healthcare Provider Details

I. General information

NPI: 1598921934
Provider Name (Legal Business Name): PATRICIA LOUISE SCALZO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2008
Last Update Date: 12/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 WATERDAM PLAZA DR BLDG 3, 2ND FLOOR
MC MURRAY PA
15317-5442
US

IV. Provider business mailing address

1307 FEDERAL ST SUITE B200
PITTSBURGH PA
15212-4769
US

V. Phone/Fax

Practice location:
  • Phone: 724-941-7490
  • Fax:
Mailing address:
  • Phone: 724-941-7490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberSP014139
License Number StatePA

VII. Legacy identifiers

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

# 1
IdentifierP00665834
Identifier TypeOTHER
Identifier StateMN
Identifier IssuerRAILROAD MEDICARE
# 2
IdentifierENROLLED
Identifier TypeMEDICAID
Identifier StateMN
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: