Provider Demographics
NPI:1760449987
Name:SCIARRINO, PETER CHARLES (MD)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:CHARLES
Last Name:SCIARRINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 STATE ST
Mailing Address - Street 2:SUITE 301H
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16507-1427
Mailing Address - Country:US
Mailing Address - Phone:814-877-5700
Mailing Address - Fax:814-877-5655
Practice Address - Street 1:300 STATE ST
Practice Address - Street 2:SUITE 301H
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16507-1427
Practice Address - Country:US
Practice Address - Phone:814-877-5700
Practice Address - Fax:814-877-5655
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD433395208800000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00010161102OtherUNIVERA
NY01094595OtherNY MEDICAID
PA1020760100001Medicaid
PA2008980OtherBLUE SHIELD
PA412107OtherUPMC
OH2805781OtherOH MEDICAID
NYD01957Medicare UPIN
NY01094595OtherNY MEDICAID