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General NPI Number Information
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NPI Number | 1154583904
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Entity Type | Organization
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Legal Business Name | THOMAS SCUDERI MD,PA
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Dates
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Enumeration Date | 07/01/2008
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Last Update Date | 07/28/2008
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Provider Practice Location Address
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Address Line | 80 HAZLET AVE SUITE 10
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City | HAZLET
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State | NJ
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Zip | 07730-1623
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Country | US
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Telephone | 732-264-0400
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Fax | 732-264-1149
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Provider Business Mailing Address
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Address Line | 80 HAZLET AVE SUITE 10
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City | HAZLET
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State | NJ
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Zip | 07730-1623
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Country | US
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Telephone | 732-264-0400
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Fax | 732-264-1149
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Authorized Official
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Title or Position | OWNER
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Name | THOMAS SCUDERI
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Credential | MD
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Telephone | 732-264-0400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | MA02982800
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License Number State | NJ
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