Provider Demographics
NPI:1447341920
Name:SCISCIONE, ANTHONY CHARLES (DO)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:CHARLES
Last Name:SCISCIONE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CENTURIAN DR
Mailing Address - Street 2:SUITE 312
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2137
Mailing Address - Country:US
Mailing Address - Phone:302-319-5680
Mailing Address - Fax:302-319-5681
Practice Address - Street 1:1 CENTURIAN DR
Practice Address - Street 2:SUITE 312
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2137
Practice Address - Country:US
Practice Address - Phone:302-319-5680
Practice Address - Fax:302-319-5681
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC2-0003420207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000455903Medicaid
DE0000455903Medicaid