Provider Demographics
NPI:1861491193
Name:SCAFFIDI, JOHN J (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:J
Last Name:SCAFFIDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:2200 HAMILTON ST STE 111
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-6329
Mailing Address - Country:US
Mailing Address - Phone:610-821-8321
Mailing Address - Fax:610-232-7952
Practice Address - Street 1:2200 HAMILTON ST STE 111
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-6329
Practice Address - Country:US
Practice Address - Phone:610-821-8321
Practice Address - Fax:610-232-7952
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-19
Last Update Date:2021-05-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD064117L174400000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAE51434Medicare UPIN
PAE51434Medicare UPIN