Provider Demographics
NPI:1306295738
Name:SCARAMUZZO, MADELEINE (MS, ATC, LAT, PES)
Entity type:Individual
Prefix:
First Name:MADELEINE
Middle Name:
Last Name:SCARAMUZZO
Suffix:
Gender:F
Credentials:MS, ATC, LAT, PES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 LASCH FOOTBALL BLDG
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PARK
Mailing Address - State:PA
Mailing Address - Zip Code:16802-1229
Mailing Address - Country:US
Mailing Address - Phone:814-321-8155
Mailing Address - Fax:
Practice Address - Street 1:109 LASCH FOOTBALL BLDG
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PARK
Practice Address - State:PA
Practice Address - Zip Code:16802-1229
Practice Address - Country:US
Practice Address - Phone:814-321-8155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-07
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0060282255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer