Provider Demographics
NPI:1740472166
Name:STEVEN A. SCALCO, M.D., A.P.M.C
Entity type:Organization
Organization Name:STEVEN A. SCALCO, M.D., A.P.M.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MAGGIE
Authorized Official - Middle Name:C
Authorized Official - Last Name:GOMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-833-0214
Mailing Address - Street 1:3812 RIDGELAKE DR
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-7255
Mailing Address - Country:US
Mailing Address - Phone:504-833-0250
Mailing Address - Fax:504-834-1486
Practice Address - Street 1:3812 RIDGELAKE DR
Practice Address - Street 2:SUITE 2B
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-7255
Practice Address - Country:US
Practice Address - Phone:504-833-0250
Practice Address - Fax:504-834-1486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-10
Last Update Date:2012-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
57363Medicare PIN