Provider Demographics
NPI:1225073679
Name:SCACCIA, ROBERT M I (PT)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:M
Last Name:SCACCIA
Suffix:I
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:60 ROCKINGHAM RD
Mailing Address - Street 2:UNIT 2
Mailing Address - City:WINDHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03087-1347
Mailing Address - Country:US
Mailing Address - Phone:603-890-8541
Mailing Address - Fax:603-890-8736
Practice Address - Street 1:60 ROCKINGHAM RD
Practice Address - Street 2:UNIT 2
Practice Address - City:WINDHAM
Practice Address - State:NH
Practice Address - Zip Code:03087-1347
Practice Address - Country:US
Practice Address - Phone:603-890-8541
Practice Address - Fax:603-890-8736
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH1736225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30391625Medicaid
NH30391625Medicaid