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General NPI Number Information
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NPI Number | 1003166000
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Entity Type | Individual
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Provider Name | BRADFORD SGRIGNOLI D.O.
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Gender | Male
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Dates
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Enumeration Date | 09/17/2012
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Last Update Date | 08/13/2019
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Provider Practice Location Address
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Address Line | 4100 LINGLESTOWN RD
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City | HARRISBURG
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State | PA
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Zip | 17112-1071
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Country | US
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Telephone | 717-657-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 4100 LINGLESTOWN RD
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City | HARRISBURG
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State | PA
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Zip | 17112-1071
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Country | US
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Telephone | 717-657-2020
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Fax | 717-657-2071
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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License Number | H0083315
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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License Number | OS017847
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License Number State | PA
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