Provider Demographics
NPI:1992838270
Name:SCALISI, ANTHONY RICHARD (RPH, PHARMD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:RICHARD
Last Name:SCALISI
Suffix:
Gender:M
Credentials:RPH, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:196 GOOSE ST
Mailing Address - Street 2:
Mailing Address - City:FLY CREEK
Mailing Address - State:NY
Mailing Address - Zip Code:13337-2310
Mailing Address - Country:US
Mailing Address - Phone:607-547-1881
Mailing Address - Fax:
Practice Address - Street 1:400 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820-2121
Practice Address - Country:US
Practice Address - Phone:607-432-3200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030315183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY030315OtherPHARAMCY LICENSE