Provider Demographics
NPI:1184626202
Name:SCIULLO, TIMOTHY JUDE (DC)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:JUDE
Last Name:SCIULLO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 VARSITY LN
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16803-1845
Mailing Address - Country:US
Mailing Address - Phone:412-523-7376
Mailing Address - Fax:412-516-3393
Practice Address - Street 1:474 WINDMERE DR STE 100
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-7643
Practice Address - Country:US
Practice Address - Phone:412-523-7376
Practice Address - Fax:412-516-3393
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-10
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003712L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA524523OtherHIGHMARK
PA253347OtherU.P.M.C.
PA3659751OtherAETNA HMO
PA0014988620003Medicaid
PA108377OtherMEDPLUS
PACIGNAOther5810335
PA1046615OtherHEALTH AMERICA
PA5918299OtherAETNA PPO
PA834805OtherUNITED HEALTH CARE
PASC524523Medicare ID - Type Unspecified
PA108377OtherMEDPLUS