Provider Demographics
NPI:1871679225
Name:SCIASCIA, GERALD (DC)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:
Last Name:SCIASCIA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1313 CLOVE RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-4338
Mailing Address - Country:US
Mailing Address - Phone:718-448-0687
Mailing Address - Fax:718-448-3463
Practice Address - Street 1:1313 CLOVE RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-4338
Practice Address - Country:US
Practice Address - Phone:718-448-0687
Practice Address - Fax:718-448-3463
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX006709111N00000X
NJ38MC00492000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC06709-1OtherWORKER'S COMPENSATION
NY2C2939OtherSMART CHOICE PROVIDER #
NY893574OtherAMERIHEALTH PROVIDER #
NY5218351OtherCIGNA PPO PROVIDER #
NY5800677OtherGHI PROVIDER NUMBER
NYP2800784OtherOXFORD PROVIDER NUMBER
NYP40683821OtherMULTIPLAN PROVIDER #
NY13362703001OtherHIP PROVIDER #
NY4559473OtherAETNA PROVIDER NUMBER
NY838370OtherFIRST HEALTH PROVIDER #
NYP2800784OtherOXFORD PROVIDER NUMBER
NYU29185Medicare UPIN