Healthcare Provider Details

I. General information

NPI: 1891617841
Provider Name (Legal Business Name): SCOTT BIRDIE EMT-P
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 MERRICK AVE
MERRICK NY
11566-4331
US

IV. Provider business mailing address

990 CORPORATE DR APT 322
WESTBURY NY
11590-6717
US

V. Phone/Fax

Practice location:
  • Phone: 516-221-7055
  • Fax:
Mailing address:
  • Phone: 516-221-7055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146E00000X
TaxonomyCommunity Paramedic
License Number191823
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: