Provider Demographics
NPI:1487689949
Name:SCARPATI, ROBERT MARTIN (OD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MARTIN
Last Name:SCARPATI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 FOREST PARK DRIVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-1428
Mailing Address - Country:US
Mailing Address - Phone:860-677-1957
Mailing Address - Fax:860-674-2793
Practice Address - Street 1:4 FOREST PARK DRIVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-1428
Practice Address - Country:US
Practice Address - Phone:860-677-1957
Practice Address - Fax:860-674-2793
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT788152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT4024428Medicaid
CT410000265Medicare ID - Type Unspecified
T22994Medicare UPIN