Basic Information
| Provider Information | |||||||||
| NPI: | 1801809173 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCOTTI | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | M. | ||||||||
| NamePrefix: | |||||||||
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| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | SCARICACIOTTOLI | ||||||||
| OtherFirstName: | DANIEL | ||||||||
| OtherMiddleName: | M. | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 335 GARDEN PARK BLVD | ||||||||
| Address2: | |||||||||
| City: | CHERRY HILL | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080024248 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8565774844 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2201 CHAPEL AVE W | ||||||||
| Address2: | ATTN: RADIOLOGY DEPARTMENT | ||||||||
| City: | CHERRY HILL | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080022048 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8566615473 | ||||||||
| FaxNumber: | 8566615470 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/15/2006 | ||||||||
| LastUpdateDate: | 03/05/2014 | ||||||||
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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 | 2085B0100X | 25MA0323500 | NJ | N | Allopathic & Osteopathic Physicians | Radiology | Body Imaging | 2085N0700X | 25MA0323500 | NJ | N | Allopathic & Osteopathic Physicians | Radiology | Neuroradiology | 2085N0904X | 25MA0323500 | NJ | N | Allopathic & Osteopathic Physicians | Radiology | Nuclear Radiology | 2085R0202X | 25MA0323500 | NJ | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0204X | 25MA0323500 | NJ | Y | Allopathic & Osteopathic Physicians | Radiology | Vascular & Interventional Radiology | 2085U0001X | 25MA0323500 | NJ | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Ultrasound |
No ID Information.