Provider Demographics
NPI:1518186766
Name:SCARCELLA, VINCENT (MS,PT)
Entity type:Individual
Prefix:MR
First Name:VINCENT
Middle Name:
Last Name:SCARCELLA
Suffix:
Gender:M
Credentials:MS,PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4532 BEACH 45TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-1002
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4532 BEACH 45TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11224-1002
Practice Address - Country:US
Practice Address - Phone:718-666-8515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020852225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY020852OtherHIP PROVIDER NMBER
NY173727OtherELDERPLAN PROVIDER NUMBER
NY6698040OtherGHI PROVIDER NUMBER
NY02121039Medicaid
NY270045OtherWELLCARE PROVIDER NUMBER
NY5507337OtherCIGNA PPO PROVIDER NUMBER
NY6698040OtherGHI PROVIDER NUMBER