Provider Demographics
NPI:1902861800
Name:SCIBETTA, JOSEPH J (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:J
Last Name:SCIBETTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:125 LATTIMORE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-4155
Mailing Address - Country:US
Mailing Address - Phone:585-461-5940
Mailing Address - Fax:585-461-2328
Practice Address - Street 1:125 LATTIMORE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-4159
Practice Address - Country:US
Practice Address - Phone:585-461-5940
Practice Address - Fax:585-461-2328
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2023-07-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY100378207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY16413BMedicare ID - Type UnspecifiedPROVIDER IDENTIFICATION
NYB72270Medicare UPIN