Provider Demographics
NPI:1437781069
Name:SCALA, RUDOLPH ANTHONY II
Entity type:Individual
Prefix:MR
First Name:RUDOLPH
Middle Name:ANTHONY
Last Name:SCALA
Suffix:II
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:RUDY
Other - Middle Name:
Other - Last Name:SCALA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 553
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10040-0803
Mailing Address - Country:US
Mailing Address - Phone:917-336-7705
Mailing Address - Fax:
Practice Address - Street 1:1000 10TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1147
Practice Address - Country:US
Practice Address - Phone:917-336-7705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-11
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health