MEDICARE: ATHANASIOS SCINAS 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	207L00000X	Anesthesiology Physician	25MA06945500	NJ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00473189	OTHER	NJ	RR MEDICARE

General Provider Information

NPI Number	:	1922000207
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ATHANASIOS SCINAS MD

Provider Business Mailing Address
First Line	:	PO BOX 35
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15230-0035
Country	:	US
Telephone Number	:	412-937-5700
Fax Number	:	770-666-9078

Provider Business Practice Location Address
First Line	:	550 NEWARK AVE
Second Line	:	5TH FLOOR
City	:	JERSEY CITY
State	:	NJ
Zip	:	07305-0550
Country	:	US
Telephone Number	:	201-795-0205
Fax Number	:

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

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	06/08/2009

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