| Organization Name: | THOMAS SCUDERI MD,PA |
| NPI Number: | 1154583904 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | THOMAS SCUDERI (OWNER) |
| Mailing Address: | 80 Hazlet Ave Suite 10 Hazlet |
| State: | NJ US |
| Postal Code: | 077301623 |
| Phone Number: | 7322640400 |
| Fax Number: | 7322641149 |
| NPI Enumeration Date: | 07/01/2008 |
| NPI Last Update Date: | 07/28/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | MA02982800 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |