Provider Demographics
NPI:1790138527
Name:SCAVO, GIA (OD)
Entity Type:Individual
Prefix:DR
First Name:GIA
Middle Name:
Last Name:SCAVO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 C G ZINN RD
Mailing Address - Street 2:
Mailing Address - City:THORNDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19372-1134
Mailing Address - Country:US
Mailing Address - Phone:610-384-9100
Mailing Address - Fax:610-384-3937
Practice Address - Street 1:3000 C G ZINN RD
Practice Address - Street 2:
Practice Address - City:THORNDALE
Practice Address - State:PA
Practice Address - Zip Code:19372-1134
Practice Address - Country:US
Practice Address - Phone:610-384-9100
Practice Address - Fax:610-384-3937
Is Sole Proprietor?:No
Enumeration Date:2016-07-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG003317152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist