Provider Demographics
NPI:1811397763
Name:SCUNCIO, PATRICIA (PTA)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:SCUNCIO
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 LORING LN
Mailing Address - Street 2:
Mailing Address - City:NORTH PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904-3012
Mailing Address - Country:US
Mailing Address - Phone:401-595-7613
Mailing Address - Fax:
Practice Address - Street 1:252 DONAHUE ROAD
Practice Address - Street 2:
Practice Address - City:PASCOAG
Practice Address - State:RI
Practice Address - Zip Code:02859
Practice Address - Country:US
Practice Address - Phone:401-595-7613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-28
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPTA 00977225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant