Provider Demographics
NPI:1346812401
Name:SCARAMUZZINO, RENEE CHRISTINA (FNP)
Entity Type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:CHRISTINA
Last Name:SCARAMUZZINO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2209 GENESEE ST.
Mailing Address - Street 2:BUSINESS OFFICE
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-5930
Mailing Address - Country:US
Mailing Address - Phone:315-801-4238
Mailing Address - Fax:315-801-8391
Practice Address - Street 1:35 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-2320
Practice Address - Country:US
Practice Address - Phone:315-735-2294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-16
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY678901163W00000X, 363LF0000X
NY348003363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse