Provider Demographics
NPI:1477307023
Name:SCANLON, SYDNEY (PA)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:
Last Name:SCANLON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1807 FALSTAFF CT
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-1568
Mailing Address - Country:US
Mailing Address - Phone:571-494-7490
Mailing Address - Fax:
Practice Address - Street 1:1807 FALSTAFF CT
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-1568
Practice Address - Country:US
Practice Address - Phone:571-494-7490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-11
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program