Provider Demographics
NPI:1285417493
Name:SCARAMUZZINO, JAMES
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:SCARAMUZZINO
Suffix:
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 1:3 GLENWOOD CT
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:CT
Mailing Address - Zip Code:06524-3334
Mailing Address - Country:US
Mailing Address - Phone:203-491-9379
Mailing Address - Fax:
Practice Address - Street 1:114 CAMP ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-1728
Practice Address - Country:US
Practice Address - Phone:203-491-9379
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician