Basic Information
| Provider Information | |||||||||
| NPI: | 1760449987 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCIARRINO | ||||||||
| FirstName: | PETER | ||||||||
| MiddleName: | CHARLES | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 STATE ST | ||||||||
| Address2: | SUITE 301H | ||||||||
| City: | ERIE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 165071427 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8148775700 | ||||||||
| FaxNumber: | 8148775655 | ||||||||
| Practice Location | |||||||||
| Address1: | 300 STATE ST | ||||||||
| Address2: | SUITE 301H | ||||||||
| City: | ERIE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 165071427 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8148775700 | ||||||||
| FaxNumber: | 8148775655 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2006 | ||||||||
| LastUpdateDate: | 03/19/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | MD433395 | PA | Y | Allopathic & Osteopathic Physicians | Urology | 208600000X | MD433395 | PA | N | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 00010161102 | 01 | NY | UNIVERA | OTHER | 01094595 | 01 | NY | NY MEDICAID | OTHER | 1020760100001 | 05 | PA | MEDICAID | 2008980 | 01 | PA | BLUE SHIELD | OTHER | 412107 | 01 | PA | UPMC | OTHER | 2805781 | 01 | OH | OH MEDICAID | OTHER |