Healthcare Provider Details

I. General information

NPI: 1871508499
Provider Name (Legal Business Name): SCOTT OFRIAS & SCOTT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 09/19/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 GRAND AVE
SHELTER ISLAND HEIGHTS NY
11965-2000
US

IV. Provider business mailing address

PO BOX 1163
SHELTER ISLAND HEIGHTS NY
11965-1163
US

V. Phone/Fax

Practice location:
  • Phone: 631-749-0445
  • Fax: 631-749-0649
Mailing address:
  • Phone: 631-749-0445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number020054
License Number StateNY

VIII. Authorized Official

Name: SUZANNE FUJITA
Title or Position: PIC,PARTNER
Credential: RPH
Phone: 631-749-0445