Provider Demographics
NPI:1346304482
Name:SCIOSCIA, JOHN V (PT)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:V
Last Name:SCIOSCIA
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 1:9 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-4011
Mailing Address - Country:US
Mailing Address - Phone:908-337-1336
Mailing Address - Fax:973-218-9717
Practice Address - Street 1:60 MORRIS TPKE STE 2W
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-5007
Practice Address - Country:US
Practice Address - Phone:908-598-9009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00251500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ025244M47Medicare ID - Type Unspecified