Provider Demographics
NPI:1952483349
Name:SCARINGE-DIETRICH, DENISE (MD)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:
Last Name:SCARINGE-DIETRICH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DENISE
Other - Middle Name:
Other - Last Name:SCARINGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:15000 MIDLANTIC DR
Mailing Address - Street 2:STE 102
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-1573
Mailing Address - Country:US
Mailing Address - Phone:855-727-2465
Mailing Address - Fax:856-393-8372
Practice Address - Street 1:15000 MIDLANTIC DR STE 102
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-1573
Practice Address - Country:US
Practice Address - Phone:855-727-2465
Practice Address - Fax:856-393-8372
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD064392L207LP2900X
DEC1-0011321208VP0000X, 208VP0014X
NJ25MA07412900208VP0014X, 2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7611901Medicaid
NJ060397YCKGMedicare UPIN
NJ7611901Medicaid
NJ060397YCKGMedicare PIN