Provider Demographics
NPI:1881613842
Name:SCIORTINO, PATRICK JOSEPH (MD)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:JOSEPH
Last Name:SCIORTINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:914 BAY RIDGE PARKWAY
Mailing Address - Street 2:
Mailing Address - City:BKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228
Mailing Address - Country:US
Mailing Address - Phone:718-748-5700
Mailing Address - Fax:718-836-9236
Practice Address - Street 1:914 BAY RIDGE PARKWAY
Practice Address - Street 2:
Practice Address - City:BKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228
Practice Address - Country:US
Practice Address - Phone:718-748-5700
Practice Address - Fax:718-836-9236
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1401411207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00847609Medicaid
B19861Medicare UPIN
NY90A481Medicare Oscar/Certification