Provider Demographics
NPI:1619147840
Name:SCARPELLI, M SUSAN (RD LBW CSR)
Entity Type:Individual
Prefix:MRS
First Name:M SUSAN
Middle Name:
Last Name:SCARPELLI
Suffix:
Gender:F
Credentials:RD LBW CSR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:894 EAST GATE CT
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502
Mailing Address - Country:US
Mailing Address - Phone:301-722-0707
Mailing Address - Fax:301-722-6050
Practice Address - Street 1:939 FREDERICK ST
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502
Practice Address - Country:US
Practice Address - Phone:301-724-0351
Practice Address - Fax:301-724-8961
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDN00255133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal