Provider Demographics
NPI:1134229537
Name:SCARPULLA, CHARLES A (DC)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:A
Last Name:SCARPULLA
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 1:516 ROUTE 303
Mailing Address - Street 2:SUITE 3
Mailing Address - City:ORANGEBURG
Mailing Address - State:NY
Mailing Address - Zip Code:10962-1309
Mailing Address - Country:US
Mailing Address - Phone:845-398-7771
Mailing Address - Fax:845-398-7777
Practice Address - Street 1:516 ROUTE 303
Practice Address - Street 2:SUITE 3
Practice Address - City:ORANGEBURG
Practice Address - State:NY
Practice Address - Zip Code:10962-1309
Practice Address - Country:US
Practice Address - Phone:845-398-7771
Practice Address - Fax:845-398-7777
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010012-1111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX2L241Medicare ID - Type UnspecifiedCHIROPRACTOR