Provider Demographics
NPI:1265803928
Name:SCAGLIONE, PAUL HARRY (LRT)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:HARRY
Last Name:SCAGLIONE
Suffix:
Gender:M
Credentials:LRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 LINDELL BLVD
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-2945
Mailing Address - Country:US
Mailing Address - Phone:516-476-6972
Mailing Address - Fax:
Practice Address - Street 1:125 LINDELL BLVD
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:NY
Practice Address - Zip Code:11561-2945
Practice Address - Country:US
Practice Address - Phone:516-476-6972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-07
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY9203042471C3401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471C3401XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistComputed Tomography