Provider Demographics
NPI:1568527042
Name:SCAFFIDI, ROSE MADELEINE (CNM)
Entity Type:Individual
Prefix:MRS
First Name:ROSE
Middle Name:MADELEINE
Last Name:SCAFFIDI
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 ENGLISH CREEK AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-5598
Mailing Address - Country:US
Mailing Address - Phone:609-677-7211
Mailing Address - Fax:
Practice Address - Street 1:2500 ENGLISH CREEK AVE STE 200
Practice Address - Street 2:
Practice Address - City:EGG HARBOR TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08234-5598
Practice Address - Country:US
Practice Address - Phone:609-677-7211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25ME00034901367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8546401Medicaid
NJ8546401Medicaid
NJ177142AEEMedicare PIN
044001SBVMedicare PIN