Healthcare Provider Details

I. General information

NPI: 1326108549
Provider Name (Legal Business Name): SCOTT KANE D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 JERICHO TPKE
JERICHO NY
11753-1351
US

IV. Provider business mailing address

224 COACH DR
WOODBURY NY
11797-2837
US

V. Phone/Fax

Practice location:
  • Phone: 516-674-0404
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number190594
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: