Individual
SHANNON SCRUDATO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
555 N DUKE ST, LANCASTER, PA 17602-2250
(717) 299-4173
(717) 295-4773
Mailing address
555 N DUKE ST, LANCASTER, PA 17602-2250
(717) 299-4173
(717) 295-4773
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
2788601-1
NY
2085R0202X
Diagnostic Radiology Physician
Primary
MD457332
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103118698
—
PA
Enumeration date
06/11/2010
Last updated
10/13/2016
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