Healthcare Provider Details

I. General information

NPI: 1629658877
Provider Name (Legal Business Name): DANIELA MARIA SCOTTO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2021
Last Update Date: 04/12/2021
Certification Date: 04/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 HACKENSACK AVE FL 7
HACKENSACK NJ
07601-6328
US

IV. Provider business mailing address

11 SPENCER DR
MORRISTOWN NJ
07960-3539
US

V. Phone/Fax

Practice location:
  • Phone: 201-465-8111
  • Fax:
Mailing address:
  • Phone: 973-525-8814
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: