Provider Demographics
NPI:1225021439
Name:SCALIA, ROBERT A (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:A
Last Name:SCALIA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 TREMONT RD
Mailing Address - Street 2:
Mailing Address - City:PINE GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:17963-8629
Mailing Address - Country:US
Mailing Address - Phone:570-915-6497
Mailing Address - Fax:570-915-6631
Practice Address - Street 1:35 TREMONT RD
Practice Address - Street 2:
Practice Address - City:PINE GROVE
Practice Address - State:PA
Practice Address - Zip Code:17963-8629
Practice Address - Country:US
Practice Address - Phone:570-915-6497
Practice Address - Fax:570-915-6631
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2015-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS007750L207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA368453OtherMEDICARE GROUP PTAN#
DV1944OtherRAILROAD MEDICARE GROUP PTAN
PA0016281070008Medicaid
P01395482OtherRAILROAD MEDICARE PROVIDER PTAN
DV1944OtherRAILROAD MEDICARE GROUP PTAN
PA0016281070008Medicaid