Healthcare Provider Details

I. General information

NPI: 1790847028
Provider Name (Legal Business Name): SCOTT AFTEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 12/16/2024
Certification Date: 12/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

247 O ST
SEASIDE PARK NJ
08752-1144
US

IV. Provider business mailing address

247 O ST
SEASIDE PARK NJ
08752-1144
US

V. Phone/Fax

Practice location:
  • Phone: 201-437-9711
  • Fax: 201-437-9111
Mailing address:
  • Phone: 201-437-9711
  • Fax: 201-437-9111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMA62189
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: