Provider Demographics
NPI:1053350595
Name:SCALPATO, ANTHONY (DPM)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:SCALPATO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 W CHESTER PIKE
Mailing Address - Street 2:344
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-2700
Mailing Address - Country:US
Mailing Address - Phone:610-789-4443
Mailing Address - Fax:610-789-1002
Practice Address - Street 1:2010 W CHESTER PIKE
Practice Address - Street 2:344
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-2700
Practice Address - Country:US
Practice Address - Phone:610-789-4443
Practice Address - Fax:610-789-1002
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC002364L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAT29206Medicare UPIN
PA117973Medicare PIN