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NPI Code Detail

MEDICARE: GINA SCALICI

MEDICARE: GINA SCALICI
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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1093457038
Entity Type Code : Individual
Provider Name (Legal Business Name) : GINA SCALICI
Provider Business Mailing Address
First Line : 3151 STONEY ST
Second Line :
City : MOHEGAN LAKE
State : NY
Zip : 10547-1913
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3151 STONEY ST
Second Line :
City : MOHEGAN LAKE
State : NY
Zip : 10547-1913
Country : US
Telephone Number : 914-885-0110
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2022
Last Update Date : 04/11/2022

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Directions to “ GINA SCALICI ” Practice Location

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