Provider Demographics
NPI:1386692002
Name:SCORTICHINI, DORIA A (MD, FACC)
Entity type:Individual
Prefix:
First Name:DORIA
Middle Name:A
Last Name:SCORTICHINI
Suffix:
Gender:F
Credentials:MD, FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 STATE ROUTE 5 AND 20
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:NY
Mailing Address - Zip Code:14456-9543
Mailing Address - Country:US
Mailing Address - Phone:315-789-5758
Mailing Address - Fax:315-789-0741
Practice Address - Street 1:1150 STATE ROUTE 5 AND 20
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:NY
Practice Address - Zip Code:14456-9543
Practice Address - Country:US
Practice Address - Phone:315-789-5758
Practice Address - Fax:315-789-0741
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY154650207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00020507201OtherUNIVERA ID#
NY00868566Medicaid
NY2197940OtherGHI PROVIDER ID#
NY000911281001OtherHEALTHNOW PROVIDER ID#
NYP010154650OtherBLUE CHOICE PROVIDER ID#
NYP010154650OtherEXCELLUS BLUE SHIELD ID#
NYRC60154650OtherDOCTORS' HEALTH PLAN ID#
NY102435BOOtherPREFERRED CARE ID#
NY2178111OtherFIRST HEALTH ID#
NY000911281001OtherHEALTHNOW PROVIDER ID#
NY2178111OtherFIRST HEALTH ID#