Healthcare Provider Details

I. General information

NPI: 1992091524
Provider Name (Legal Business Name): AICHA KATHERINE SCOTT CNM, WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2011
Last Update Date: 06/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 PELHAM PKWY S 3RD FLOOR, GYN CLINIC
BRONX NY
10461-1138
US

IV. Provider business mailing address

1400 PELHAM PAKRWAY SOUTH 3RD FLOOR, GYN CLINIC
BRONX NY
10461-1119
US

V. Phone/Fax

Practice location:
  • Phone: 718-918-3600
  • Fax:
Mailing address:
  • Phone: 718-918-3600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number7359143
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number7394787
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: