Provider Demographics
NPI:1982998613
Name:SCAFIDI, JOHN PAUL (PT)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:PAUL
Last Name:SCAFIDI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 APRIL WAY
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07748-6510
Mailing Address - Country:US
Mailing Address - Phone:732-614-2323
Mailing Address - Fax:
Practice Address - Street 1:1212 HWY 34
Practice Address - Street 2:SUITE 24-25
Practice Address - City:ABERDEEN
Practice Address - State:NJ
Practice Address - Zip Code:07747-1903
Practice Address - Country:US
Practice Address - Phone:732-614-2323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-28
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01273000225100000X
MA17892225100000X
NY032524225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist