Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | X010012-1 | NY |
NPI | 1134229537 |
---|---|
Provider Name | Dr. Charles A Scarpulla |
First Address | Orangeburg, NY 10962-1309 |
Second Address | Orangeburg, NY 10962-1309 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2006 |
Last Update Date | 08/07/2007 |