Provider Demographics
NPI:1508279464
Name:SCAMINACE, JOSEPH (CNP)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:SCAMINACE
Suffix:
Gender:M
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12000 MCCRACKEN RD STE 201
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-2933
Mailing Address - Country:US
Mailing Address - Phone:216-662-5600
Mailing Address - Fax:
Practice Address - Street 1:12000 MCCRACKEN RD STE 201
Practice Address - Street 2:
Practice Address - City:GARFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44125-2933
Practice Address - Country:US
Practice Address - Phone:216-662-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.15953-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner