Provider Demographics
NPI:1124183645
Name:PLADEL, SCOTT (PA-C)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:PLADEL
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-6644
Mailing Address - Country:US
Mailing Address - Phone:781-665-9500
Mailing Address - Fax:781-665-3856
Practice Address - Street 1:405 PEARL ST
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-6644
Practice Address - Country:US
Practice Address - Phone:781-665-9500
Practice Address - Fax:781-665-3856
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAS71255Medicare UPIN