Individual
SHANE SCAVELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
133 OLD ROAD TO 9 ACRE COR, CONCORD, MA 01742-4159
(978) 369-1400
Mailing address
5 SESAME ST, WESTERLY, RI 02891-1304
(401) 378-3521
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
PA01516
RI
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
11/04/2020
Last updated
12/28/2022
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