Provider Demographics
NPI:1033539879
Name:SCANGARELLO, SARA
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:SCANGARELLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8108 BAY TER
Mailing Address - Street 2:
Mailing Address - City:HARVEY CEDARS
Mailing Address - State:NJ
Mailing Address - Zip Code:08008-5938
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8108 BAY TER
Practice Address - Street 2:
Practice Address - City:HARVEY CEDARS
Practice Address - State:NJ
Practice Address - Zip Code:08008-5938
Practice Address - Country:US
Practice Address - Phone:609-709-0331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-20
Last Update Date:2014-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00649000225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist