Provider Demographics
NPI:1619569860
Name:SCIULLO, PATRICIA MARIE
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:MARIE
Last Name:SCIULLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 BRADLEY RD
Mailing Address - Street 2:
Mailing Address - City:STONEBORO
Mailing Address - State:PA
Mailing Address - Zip Code:16153-3221
Mailing Address - Country:US
Mailing Address - Phone:412-628-6309
Mailing Address - Fax:
Practice Address - Street 1:711 BRADLEY RD
Practice Address - Street 2:
Practice Address - City:STONEBORO
Practice Address - State:PA
Practice Address - Zip Code:16153-3221
Practice Address - Country:US
Practice Address - Phone:412-628-6309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-09
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy