Provider Demographics
NPI:1578557401
Name:SCALESE, MATTHEW T (PT)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:T
Last Name:SCALESE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5 MORGAN HWY
Mailing Address - Street 2:SUITE 4
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18508-2641
Mailing Address - Country:US
Mailing Address - Phone:570-344-3788
Mailing Address - Fax:570-969-9280
Practice Address - Street 1:5 MORGAN HWY
Practice Address - Street 2:SUITE 4
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18508-2641
Practice Address - Country:US
Practice Address - Phone:570-344-3788
Practice Address - Fax:570-969-9280
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAPT011807L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001702320Medicaid
PA1578557401OtherUHC COMMERCIAL
PAP00016183OtherRAILROAD MEDICARE
PA66866-159BOtherGEISINGER HEALTH PLAN
PASC974488OtherPA BLUE SHIELD
PA1578557401OtherCOVENTRY-HEALTH AMERICA-HEALTH ASSURANCE
PA5414658OtherAETNA
PA816686OtherFIRST PRIORITY HEALTH
PA1578557401OtherHUMANA/CHOICE CARE
PA3263156OtherUS HEALTHCARE
PA001702320Medicaid
PASC974488OtherPA BLUE SHIELD