Provider Demographics
NPI:1871275479
Name:SCANDAGLIA, JULIE L
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:L
Last Name:SCANDAGLIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2428 COLUMBIA PL
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-4207
Mailing Address - Country:US
Mailing Address - Phone:516-353-3008
Mailing Address - Fax:
Practice Address - Street 1:2428 COLUMBIA PL
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-4207
Practice Address - Country:US
Practice Address - Phone:516-353-3008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency