Provider Demographics
NPI:1215530399
Name:SCIARRA, THOMAS JAY JR
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:JAY
Last Name:SCIARRA
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 CLEARWATER DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-9531
Mailing Address - Country:US
Mailing Address - Phone:828-334-2937
Mailing Address - Fax:
Practice Address - Street 1:129 CLEARWATER DR
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-9531
Practice Address - Country:US
Practice Address - Phone:828-334-2937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC83343164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse