ROBERT CHRISTOPHER SCALISE (NPI# 1700340106) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1700340106 |
Entity Type | Individual |
Full Name | ROBERT CHRISTOPHER SCALISE |
Credential | DO |
Practice Address |
59 Sequin Dr Groton CT 06340-5510 |
Mailing Address |
1 Wahoo Drive Medical Clinic, Occupational Health Groton CT 06349 |
Practice Telephone | 6198829148 |
Mailing Telephone | 8606944910 |
Enumeration Date | 2019-01-30 |
Last Update Date | 2019-01-30 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 171000000X | Military Health Care Provider | 5101018005 | MI | Other Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MI | MICHIGAN STATE MEDICAL LICENSE | 5101018005 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255887543 | Robert Scalise | Behavioral Analyst | 500 N Rainbow Blvd Ste 300a, Las Vegas, NV 89107-1061 | 2016-08-28 |
Street Address |
59 SEQUIN DR |
City | GROTON |
State | CT |
Zip Code | 06340-5510 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912558610 | Bruce Lancel Bernardo Lara | Military Health Care Provider | Fpo, Ae, 09587-2417, Groton, AE 06340 | 2019-09-24 |
1295393692 | Ermelinda Elaine Alviso | Military Health Care Provider | Trout Ave, Groton, CT 06340 | 2019-05-31 |
1679034011 | Derek James Hale | Military Health Care Provider | Fc 83 Numi, Trout Ave, Groton, CT 06340 | 2019-03-28 |
1063973790 | Cody Eugene Shaw | Military Health Care Provider | Numi, Trout Ave Building 83, Groton, CT 06340 | 2019-03-26 |
1265906911 | Homelife Companions and Homemakers, LLC | Adult Companion | 1 Fort Hill Road, Suite 3, Groton, CT 06340 | 2019-01-16 |
1144735457 | Kristina Marie Carta | Behavior Technician | 220 Rt 12, Suite 205, Groton, CT 06340 | 2017-12-08 |
1538674262 | Tercel Dental Pllc | Dentist | 643 Gold Star Hwy., Groton, CT 06340 | 2017-12-04 |
1306361662 | Stonington Behavioral Health Inc | Psychologist | 618 Poquonnock Rd, Groton, CT 06340 | 2017-08-08 |
1104347806 | Renae Reynolds | Optometrist | 489 Gold Star Hwy Ste 100, Groton, CT 06340 | 2017-07-03 |
1053831552 | Susan A Bradbury | Physical Therapist | 455 Eastern Point Rd, Groton, CT 06340 | 2017-06-26 |
Find all providers in zip 06340 |
Taxonomy Code | 171000000X |
Grouping | Other Service Providers |
Classification | Military Health Care Provider |
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |
Notes: [7/1/2005: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912558610 | Bruce Lancel Bernardo Lara | Military Health Care Provider | Fpo, Ae, 09587-2417, Groton, AE 06340 | 2019-09-24 |
1386965812 | Kevin Ford Wilson | Military Health Care Provider | 1 Wahoo Ave # 600, Groton, CT 06349-2324 | 2010-06-18 |
1043286701 | Meghan Elizabeth Wolf | Military Health Care Provider | 15 Mohegan Rd, Groton, CT 06340-5504 | 2006-02-23 |
1811470628 | Michael Noel Alonzo Peralta | Military Health Care Provider | 1 Wahoo Ave, Groton, CT 06349-2324 | 2018-09-08 |
1427443597 | Luke Beardslee | Military Health Care Provider | 1 Wahoo Ave, Groton, CT 06349-2324 | 2015-04-05 |
1316264138 | Paul B. Schiowitz | Military Health Care Provider | 1 Wahoo Ave, Groton, CT 06340-2324 | 2010-05-04 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972793487 | Brenda Ariana Garzawilliams | Military Health Care Provider | 15 Mohegan Ave, New London, CT 06320-8100 | 2007-07-31 |
1639369218 | Duong Hoang Nguyen | Military Health Care Provider | 15 Mohegan Ave, New London, CT 06320-8100 | 2007-07-30 |
1063614949 | Jacqueline Michelle Harrison | Military Health Care Provider | 15 Mohegan Ave, New London, CT 06320-8100 | 2007-06-04 |
1962509125 | Lisa A Larrivee | Military Health Care Provider | 15 Mohegan Ave, New London, CT 06320-8100 | 2006-09-20 |
1285732057 | Athena Fried | Military Health Care Provider | 15 Mohegan Ave, New London, CT 06320-8100 | 2006-09-20 |
1396702692 | Lena Shearer | Military Health Care Provider | 15 Mohegan Ave, Michael Hall, New London, CT 06320-8100 | 2006-04-28 |
1790751972 | Zachary Chancellor Hagerman | Military Health Care Provider | 15 Mohegan Ave, New London, CT 06320-8100 | 2006-02-27 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.