MEDICARE: CAROL J SCICUTELLA D.O.

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	2085R0001X	Radiation Oncology Physician	OS006474E	PA

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

General Provider Information

NPI Number	:	1467425074
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL J SCICUTELLA D.O.

Provider Business Mailing Address
First Line	:	1600 CORAOPOLIS HEIGHTS RD
Second Line	:	DEPT OF RADIATION ONCOLOGY
City	:	MOON TOWNSHIP
State	:	PA
Zip	:	15108-4316
Country	:	US
Telephone Number	:	412-604-2020
Fax Number	:	412-604-2046

Provider Business Practice Location Address
First Line	:	1600 CORAOPOLIS HEIGHTS RD
Second Line	:	DEPT OF RADIATION ONCOLOGY
City	:	MOON TOWNSHIP
State	:	PA
Zip	:	15108-4316
Country	:	US
Telephone Number	:	412-604-2020
Fax Number	:	412-604-2046

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

Provider Enumeration Date	:	02/13/2006
Last Update Date	:	01/28/2008

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