Provider Demographics
NPI:1639113863
Name:SCUDERI, GILES (MD)
Entity Type:Individual
Prefix:DR
First Name:GILES
Middle Name:
Last Name:SCUDERI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 E 64TH ST
Mailing Address - Street 2:ISK INSTITUTE 4 FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-7471
Mailing Address - Country:US
Mailing Address - Phone:212-434-4300
Mailing Address - Fax:
Practice Address - Street 1:210 E 64TH ST
Practice Address - Street 2:ISK INSTITUTE 4 FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-7471
Practice Address - Country:US
Practice Address - Phone:212-434-4300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY155338207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY27E691Medicare ID - Type Unspecified
NYA61771Medicare UPIN