Provider Demographics
NPI:1083698161
Name:SCROPPO, JOE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOE
Middle Name:
Last Name:SCROPPO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:JOE SCROPPO, PH.D., J.D.
Mailing Address - Street 2:1209 E. BROADWAY UNIT D 14
Mailing Address - City:HEWLETT
Mailing Address - State:NY
Mailing Address - Zip Code:11557-2429
Mailing Address - Country:US
Mailing Address - Phone:516-791-1438
Mailing Address - Fax:800-441-9772
Practice Address - Street 1:999 CENTRAL AVE STE 102
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-1205
Practice Address - Country:US
Practice Address - Phone:516-791-1438
Practice Address - Fax:800-441-9772
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013277103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02115855Medicaid
NY02115855Medicaid