Provider Demographics
NPI:1336337039
Name:SCARANO, GERARD ANTHONY (MSCP, MED, ED)
Entity Type:Individual
Prefix:DR
First Name:GERARD
Middle Name:ANTHONY
Last Name:SCARANO
Suffix:
Gender:M
Credentials:MSCP, MED, ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85701
Mailing Address - Country:US
Mailing Address - Phone:520-225-2000
Mailing Address - Fax:520-225-2001
Practice Address - Street 1:10 E 10TH ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85701
Practice Address - Country:US
Practice Address - Phone:520-225-2000
Practice Address - Fax:520-225-2001
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH59083103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ975 758Medicaid