Provider Demographics
NPI:1518151927
Name:SCARABINO, KARISSA (DO, MPH)
Entity Type:Individual
Prefix:
First Name:KARISSA
Middle Name:
Last Name:SCARABINO
Suffix:
Gender:F
Credentials:DO, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:990 STATE ROUTE 67
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BALLSTON SPA
Mailing Address - State:NY
Mailing Address - Zip Code:12020-3603
Mailing Address - Country:US
Mailing Address - Phone:518-889-8450
Mailing Address - Fax:518-889-8451
Practice Address - Street 1:990 STATE ROUTE 67
Practice Address - Street 2:SUITE 101
Practice Address - City:BALLSTON SPA
Practice Address - State:NY
Practice Address - Zip Code:12020-3603
Practice Address - Country:US
Practice Address - Phone:518-889-8450
Practice Address - Fax:518-889-8451
Is Sole Proprietor?:No
Enumeration Date:2007-08-29
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY255604207Q00000X, 204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03190503Medicaid
NYJ400011791Medicare PIN