Provider Demographics
NPI:1528072907
Name:SCARPELLO, DIANE T (DO)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:T
Last Name:SCARPELLO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2376 MORRIS AVE
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-5707
Mailing Address - Country:US
Mailing Address - Phone:908-686-6616
Mailing Address - Fax:908-686-5806
Practice Address - Street 1:2376 MORRIS AVE
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-5707
Practice Address - Country:US
Practice Address - Phone:908-686-6616
Practice Address - Fax:908-686-5806
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB06983700207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF72073Medicare UPIN
NJSC053971Medicare ID - Type Unspecified