Provider Demographics
NPI:1417194366
Name:SCARANO, PHILIP ROCCO (DC)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:ROCCO
Last Name:SCARANO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 OVERLOOK RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:13365-5704
Mailing Address - Country:US
Mailing Address - Phone:315-868-7080
Mailing Address - Fax:
Practice Address - Street 1:123 SARATOGA RD
Practice Address - Street 2:
Practice Address - City:GLENVILLE
Practice Address - State:NY
Practice Address - Zip Code:12302-4181
Practice Address - Country:US
Practice Address - Phone:315-868-7080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-14
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011647111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor