Healthcare Provider Details

I. General information

NPI: 1063481422
Provider Name (Legal Business Name): SCOTT ALLAN TREUTLEIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 05/21/2021
Certification Date: 05/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 S MAIN ST
WARSAW NY
14569-1567
US

IV. Provider business mailing address

121 S MAIN ST
WARSAW NY
14569-1567
US

V. Phone/Fax

Practice location:
  • Phone: 585-786-8350
  • Fax: 585-786-8362
Mailing address:
  • Phone: 585-786-8350
  • Fax: 585-786-8362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number231977-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: