Provider Demographics
NPI:1225003007
Name:SCIPIONE, LORELEE MARIE (PA)
Entity Type:Individual
Prefix:
First Name:LORELEE
Middle Name:MARIE
Last Name:SCIPIONE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 MORGAN AVE
Mailing Address - Street 2:
Mailing Address - City:NEWBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01951-1213
Mailing Address - Country:US
Mailing Address - Phone:978-358-8682
Mailing Address - Fax:
Practice Address - Street 1:255 LOW ST
Practice Address - Street 2:SUITE #303
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-3594
Practice Address - Country:US
Practice Address - Phone:978-992-1848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA16645363A00000X
MAPA4730363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant