Basic Information
| Provider Information | |||||||||
| NPI: | 1174682355 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCALISE | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | JAMES | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | OTR, CHT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 176 N VILLAGE AVE | ||||||||
| Address2: | SUITE 2C | ||||||||
| City: | ROCKVILLE CENTRE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115703800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5162554263 | ||||||||
| FaxNumber: | 5162554050 | ||||||||
| Practice Location | |||||||||
| Address1: | 176 N VILLAGE AVE | ||||||||
| Address2: | SUITE 2C | ||||||||
| City: | ROCKVILLE CENTRE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115703800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5162554263 | ||||||||
| FaxNumber: | 5162554050 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/06/2006 | ||||||||
| LastUpdateDate: | 06/28/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225XH1200X | 003241 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Hand |
No ID Information.