Provider Demographics
NPI:1487683751
Name:CHARLES J. SCAGLIOTTI, MD
Entity Type:Organization
Organization Name:CHARLES J. SCAGLIOTTI, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:A
Authorized Official - Last Name:MERCIER
Authorized Official - Suffix:
Authorized Official - Credentials:CMA
Authorized Official - Phone:610-770-3270
Mailing Address - Street 1:1210 S. CEDAR CREST BLVD.
Mailing Address - Street 2:SUITE 3000
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103
Mailing Address - Country:US
Mailing Address - Phone:610-770-3270
Mailing Address - Fax:610-432-3249
Practice Address - Street 1:1210 S CEDAR CREST BLVD
Practice Address - Street 2:SUITE 3000
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6229
Practice Address - Country:US
Practice Address - Phone:610-770-3270
Practice Address - Fax:610-432-3249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD032904L208600000X
PAMD428579208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA02356100OtherKEYSTONE CENTRAL
PA1077454OtherFIRST HEALTH
PA1808787OtherBLUE SHIELD PERSONAL CHOI
PA2168732OtherAETNA USHC
PA127370OtherTHREE RIVERS & MED PLUS
PA14339OtherGEISINGER
PA01004101OtherCAPITAL BLUE CROSS
PA0758760Medicaid
PA1526126OtherGATEWAY
PA0040083000OtherINDEPENDENCE BLUE CROSS
PA1057378001OtherCIGNA
PA1106985OtherAMERIHEALTH MERCY
PA19260OtherHEATLH ASSURANCE
PA2646498000OtherKEYSTONE EAST
PA2168732OtherAETNA USHC
PA19260OtherHEATLH ASSURANCE