Provider Demographics
NPI:1548718000
Name:SCARIA, TREESA JOSEPH
Entity type:Individual
Prefix:MRS
First Name:TREESA
Middle Name:JOSEPH
Last Name:SCARIA
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:TREESA
Other - Middle Name:
Other - Last Name:JOSEPH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:3551 DANE ST
Mailing Address - Street 2:
Mailing Address - City:SHRUB OAK
Mailing Address - State:NY
Mailing Address - Zip Code:10588-1803
Mailing Address - Country:US
Mailing Address - Phone:914-930-7109
Mailing Address - Fax:
Practice Address - Street 1:3551 DANE ST
Practice Address - Street 2:
Practice Address - City:SHRUB OAK
Practice Address - State:NY
Practice Address - Zip Code:10588-1803
Practice Address - Country:US
Practice Address - Phone:914-930-7109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-13
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY382664363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics