Provider Demographics
NPI:1811029275
Name:SCARLATA, CHRIS (ATC)
Entity Type:Individual
Prefix:MR
First Name:CHRIS
Middle Name:
Last Name:SCARLATA
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 MACK ST
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:NY
Mailing Address - Zip Code:13073-1354
Mailing Address - Country:US
Mailing Address - Phone:607-255-4237
Mailing Address - Fax:
Practice Address - Street 1:TEAGLE HALL
Practice Address - Street 2:CAMPUS RD.
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14853
Practice Address - Country:US
Practice Address - Phone:607-255-4237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000148-12255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer