Provider Demographics
NPI:1114109584
Name:SCARMOZZI, JESSICA ANN (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:ANN
Last Name:SCARMOZZI
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 WINSOME WAY
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-6313
Mailing Address - Country:US
Mailing Address - Phone:302-598-7267
Mailing Address - Fax:
Practice Address - Street 1:904 CHURCHMANS ROAD EXT
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-3151
Practice Address - Country:US
Practice Address - Phone:302-323-1118
Practice Address - Fax:302-323-1173
Is Sole Proprietor?:No
Enumeration Date:2007-11-28
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEU1-0001374225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE225X00000XMedicaid