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General NPI Number Information
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NPI Number | 1538419973
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Entity Type | Organization
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Legal Business Name | SCOTT FIERMAN SERVICES
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Dates
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Enumeration Date | 09/13/2012
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Last Update Date | 09/13/2012
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Provider Practice Location Address
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Address Line | 31 OHAYO MOUNTAIN RD
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City | WOODSTOCK
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State | NY
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Zip | 12498-1441
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Country | US
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Telephone | 347-260-2235
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Fax |
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Provider Business Mailing Address
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Address Line | 31 OHAYO MOUNTAIN RD
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City | WOODSTOCK
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State | NY
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Zip | 12498-1441
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. SCOTT ATTICUS FIERMAN
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Credential | MSED
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Telephone | 347-260-2235
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | CERTIFIED
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License Number State | NY
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