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General NPI Number Information
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NPI Number | 1215890496
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Entity Type | Individual
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Provider Name | MR. CHRISTOPHER FONSECA SCUCATO
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Gender | Male
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Dates
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Enumeration Date | 12/04/2025
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 519 WILLETT AVE
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City | PORT CHESTER
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State | NY
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Zip | 10573-3127
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Country | US
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Telephone | 917-772-7671
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Fax |
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Provider Business Mailing Address
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Address Line | 519 WILLETT AVE
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City | PORT CHESTER
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State | NY
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Zip | 10573-3127
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Country | US
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Telephone | 917-772-7671
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Fax |
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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 | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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