Provider Demographics
NPI:1295179695
Name:FRANK J SCACCIA M.D.,F.A.C.S.,L.L.C
Entity Type:Organization
Organization Name:FRANK J SCACCIA M.D.,F.A.C.S.,L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCACCIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-747-5300
Mailing Address - Street 1:70 E FRONT ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-1851
Mailing Address - Country:US
Mailing Address - Phone:732-747-5300
Mailing Address - Fax:732-747-9922
Practice Address - Street 1:305 SEGUINE AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10309-3709
Practice Address - Country:US
Practice Address - Phone:732-747-5300
Practice Address - Fax:732-747-9922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Single Specialty