MEDICARE: DR. DEBORAH A SCULCO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician	60470	GA
2	207RH0003X	Hematology & Oncology Physician	259006	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013910660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBORAH A SCULCO MD

Provider Business Mailing Address
First Line	:	4950 STATE HIGHWAY 30
Second Line	:	CANCER MEDICINE CENTER
City	:	AMSTERDAM
State	:	NY
Zip	:	12010-7520
Country	:	US
Telephone Number	:	518-770-7557
Fax Number	:	518-770-7558

Provider Business Practice Location Address
First Line	:	4950 STATE HIGHWAY 30
Second Line	:	CANCER MEDICINE CENTER
City	:	AMSTERDAM
State	:	NY
Zip	:	12010-7520
Country	:	US
Telephone Number	:	518-770-7557
Fax Number	:	518-770-7558

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	01/30/2017

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