MEDICARE: KHIARA FAY SCOLARI PA

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	363A00000X	Physician Assistant	022945	NY
2	363A00000X	Physician Assistant	PA.0007797	CO
3	363A00000X	Physician Assistant	PA62119	CA

General Provider Information

NPI Number	:	1962979690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KHIARA FAY SCOLARI PA

Provider Business Mailing Address
First Line	:	35 CHESTNUT HILL RD
Second Line	:
City	:	CHELMSFORD
State	:	MA
Zip	:	01824-1935
Country	:	US
Telephone Number	:	978-436-1018
Fax Number	:

Provider Business Practice Location Address
First Line	:	23929 MCBEAN PKWY STE 215
Second Line	:
City	:	VALENCIA
State	:	CA
Zip	:	91355-4468
Country	:	US
Telephone Number	:	661-799-2542
Fax Number	:

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

Provider Enumeration Date	:	10/31/2018
Last Update Date	:	09/13/2024

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