Provider Demographics
NPI:1053456996
Name:SCIARRINO, JOSEPH NICHOLAS
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:NICHOLAS
Last Name:SCIARRINO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 MORGAN STREET
Mailing Address - Street 2:STE 307 AND 308
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905
Mailing Address - Country:US
Mailing Address - Phone:203-967-3707
Mailing Address - Fax:203-967-8333
Practice Address - Street 1:90 MORGAN STREET
Practice Address - Street 2:SUITE 307 AND SUITE 308
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905
Practice Address - Country:US
Practice Address - Phone:203-967-3707
Practice Address - Fax:203-967-8333
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT69011223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery