Provider Demographics
NPI:1902950512
Name:SCAGLIONE PROSTHETICS INC
Entity Type:Organization
Organization Name:SCAGLIONE PROSTHETICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCAGLIONE
Authorized Official - Suffix:
Authorized Official - Credentials:CP
Authorized Official - Phone:315-793-8331
Mailing Address - Street 1:514 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13501-1207
Mailing Address - Country:US
Mailing Address - Phone:315-793-8331
Mailing Address - Fax:315-793-8332
Practice Address - Street 1:514 BROAD ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-1207
Practice Address - Country:US
Practice Address - Phone:315-793-8331
Practice Address - Fax:315-793-8332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00760545Medicaid
NY0160960001Medicare NSC